Organization · Type 2 NPI

Park Waverly Healthcare LLC

Skilled Nursing Facility · Tucson, AZ

NPI number 1629079975 Active

Practice location

2001 North Park Avenue
Tucson, AZ 85719-3558

Fax (520) 620-1547

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	NCI-2639 (AZ)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

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NPI record

NPI: 1629079975
Entity type: Organization (Type 2)
Issued: Aug 9, 2005
Last updated: Feb 16, 2021
Status: Active

Other names

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Park Avenue Health and Rehabilitaion Center · doing business as
Park Avenue Health and Rehabilitaion Center · doing business as

Authorized official

Ms. Soon Burnam
Authorized Agent
(949) 540-1249

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1629079975

Park Waverly Healthcare LLC's National Provider Identifier is 1629079975, issued on Aug 9, 2005. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Tucson, AZ. The record was last updated on Feb 16, 2021.