Provider Demographics
NPI:1932607363
Name:JRT HEALTHCARE, INC.
Entity Type:Organization
Organization Name:JRT HEALTHCARE, INC.
Other - Org Name:PARKE VIEW REHABILITATION AND CARE CENTER OUTPATIENT THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:SOON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-540-1249
Mailing Address - Street 1:2303 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BURLEY
Mailing Address - State:ID
Mailing Address - Zip Code:83318-2106
Mailing Address - Country:US
Mailing Address - Phone:208-677-3073
Mailing Address - Fax:208-677-9814
Practice Address - Street 1:2303 PARK AVE
Practice Address - Street 2:
Practice Address - City:BURLEY
Practice Address - State:ID
Practice Address - Zip Code:83318-2106
Practice Address - Country:US
Practice Address - Phone:208-677-3073
Practice Address - Fax:208-677-9814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)