Evergreen Valley Nursing Home

LBN: Evergreen Valley Nursing Home
Evergreen Valley Nursing Home is an health care organization with primary practice located at 8 Bushey Blvd. , Plattsburgh NY 12901-3785. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Evergreen Valley Nursing Home can be contacted via phone (518) 563-3261, or through Zagelbaum, Ephraim via phone (914) 597-7600.

Contact Information

Primary practice address
8 Bushey Blvd. Plattsburgh NY 12901-3785
Phone: (518) 563-3261
Fax: (518) 562-1367
Website:
Map and Directions
Authorized official contact:
Name: Zagelbaum, Ephraim
Phone: (914) 597-7600

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 0901301N New York

Profile Details

NPI number 1477540193
LBN Legal business name Evergreen Valley Nursing Home
DBA Doing business as
Authorized official Zagelbaum, Ephraim
Entity Organization
Organization subpart 1 No
Enumeration date Sep 29th, 2005
Last updated Sep 21st, 2015 - about 10 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 1477540193 NPPES
New York MEDICAID 00308801
New York MEDICAID 02329757

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