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:
Health care specialties
| Specialty | Code | License # | 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 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649453960 | NPPES |
| Washington | MEDICAID | 1995620 |
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