Evergreen Manor Health And Rehabilitation Center
LBN: Evergreen Washington Healthcare Manor, L.L.C.
Evergreen Manor Health And Rehabilitation Center is an health care organization with primary practice located at 1330 11Th Ave , Longview WA 98632-3817. 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 Washington Healthcare Manor, L.L.C. can be contacted via phone (360) 425-6706, or through Patterson, Dale L. via phone (360) 892-6628.
Contact Information
Primary practice address
1330 11Th Ave
Longview WA 98632-3817
Phone: (360) 425-6706
Fax: (360) 423-3002
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | 1226 | Washington |
Profile Details
| NPI number | 1619925328 |
|---|---|
| LBN Legal business name | Evergreen Washington Healthcare Manor, L.L.C. |
| DBA Doing business as | Evergreen Manor Health And Rehabilitation Center |
| Authorized official | Patterson, Dale L. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 5th, 2006 |
| Last updated | Jul 7th, 2008 - about 16 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 | 1619925328 | NPPES |
| Washington | MEDICAID | 4112264 |
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