Evergreen Manor - Summit Opt

LBN: Evergreen Manor - Summit Opt
Evergreen Manor - Summit Opt is an health care organization with primary practice located at 2601 Summit Ave , Everett WA 98201-3309. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Marriage & Family Therapist, Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder is the primary health care specialty. Evergreen Manor - Summit Opt can be contacted via phone (425) 258-2407, or through Grant, Linda via phone (425) 258-2407.

Contact Information

Primary practice address
2601 Summit Ave Everett WA 98201-3309
Phone: (425) 258-2407
Fax: (425) 339-2601
Website:
Map and Directions
Authorized official contact:
Name: Grant, Linda MS CDP
Phone: (425) 258-2407

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 263 Washington
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 263 Washington
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X 31-0108-03 Washington

Profile Details

NPI number 1649453960
LBN Legal business name Evergreen Manor - Summit Opt
DBA Doing business as
Authorized official Grant, Linda MS CDP
Entity Organization
Organization subpart 1 Yes
Enumeration date Dec 10th, 2007
Last updated Apr 24th, 2012 - about 13 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1649453960 NPPES
Washington MEDICAID 1995620

Popular Providers