Evergreen Manor Residential

LBN: Evergreen Manor Residential
Evergreen Manor Residential is an health care organization with primary practice located at 2601 Summit Ave , Everett WA 98201. The organization recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as the primary health care specialty. Evergreen Manor Residential can be contacted via phone (425) 258-2407, or through Gr, Linda K via phone (425) 258-2407.

Contact Information

Primary practice address
2601 Summit Ave Everett WA 98201
Phone: (425) 258-2407
Fax: (425) 339-2601
Website:
Map and Directions
Authorized official contact:
Name: Gr, Linda K MS CDP
Phone: (425) 258-2407

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility 324500000X 31 0108 01 Washington

Profile Details

NPI number 1215067319
LBN Legal business name Evergreen Manor Residential
DBA Doing business as
Authorized official Gr, Linda K MS CDP
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 7th, 2007
Last updated Oct 30th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215067319 NPPES
Washington MEDICAID 1995133

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