EVERGREEN RECOVERY CENTERS (NPI# 1023515400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023515400 |
| Entity Type | Organization |
| Organization Name | EVERGREEN RECOVERY CENTERS |
| Practice Address |
1905 Continental Place Mount Vernon WA 98273 |
| Mailing Address |
Po Box 12598 Everett WA 98206 |
| Practice Telephone | 3607556400 |
| Mailing Telephone | 4254935310 |
| Mailing Fax Number | 4252639706 |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |
| Authorized Official Name | MS. LINDA K GRANT (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 4252582485 |
| Authorized Official Credential | MS, CDP |
| Is Organization Subpart | Y |
| Parent Organization Name | EVERGREEN RECOVERY CENTERS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EVERGREEN RECOVERY CENTERS | 11627 Airport Rd Ste B, Everett, WA 98204-8714 |
| Street Address |
1905 CONTINENTAL PLACE |
| City | MOUNT VERNON |
| State | WA |
| Zip Code | 98273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710585849 | Stephanie Marie Partington | Physical Therapist | 1901 Hoad Road, Mount Vernon, WA 98273 | 2020-10-12 |
| 1447866165 | Jennifer I Campos | Interpreter | 1501 Sunset Pl., Unit B, Mount Vernon, WA 98273 | 2020-09-17 |
| 1487217345 | Nicholas Peter Goodman | Student in an Organized Health Care Education/Training Program | Attn: Internal Medicine Residency, 300 Hospital Parkway, Mount Vernon, WA 98273 | 2019-04-17 |
| 1023579430 | Joan Watkins Opyr | Registered Nurse | Telecare North Sound E&t, 7825 North Sound Drive, Sedro-woolley, WA 98273 | 2019-03-28 |
| 1588136188 | Nicholas Bryan Corp | Physical Therapy Assistant | 1901 Hoag Road, Mount Vernon, WA 98273 | 2018-12-20 |
| 1518437300 | Eyonna Mason | Case Manager/Care Coordinator | 1100 52nd St, Mount Vernon, WA 98273 | 2018-12-05 |
| 1104320480 | Stacy Anne Black | Marriage & Family Therapist | 2301 Old Hwy 99, Mt. Vernon, WA 98273 | 2018-03-21 |
| 1609387844 | Kerri Jesse | Massage Therapist | 210 N 23rd St, Mount Vernon, WA 98273 | 2017-10-16 |
| 1992225320 | Juana Cleek | Registered Nurse | 330 Pacific Place, Mount Vernon, WA 98273 | 2017-06-27 |
| 1316472780 | Maria Angelica Walcott | Social Worker | 1005 S. 3rd Street, Mount Vernon, WA 98273 | 2017-04-24 |
| Find all providers in zip 98273 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104450063 | Quest Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 401 W High St Ste 9, Mount Vernon, OH 43050-2346 | 2020-02-28 |
| 1225699358 | Mount Vernon Recovery Inc | Substance Abuse Rehabilitation Facility | 521 Wooster Rd, Mount Vernon, OH 43050-1430 | 2019-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730787763 | For The Culture Counseling Services | Substance Abuse Rehabilitation Facility | 4301 S Pine St Ste 92, Tacoma, WA 98409-7259 | 2020-10-12 |
| 1760090518 | Hotel California By The Sea Bellevue, LLC. | Substance Abuse Rehabilitation Facility | 7810 130th Ave Ne, Kirkland, WA 98033-8251 | 2020-07-17 |
| 1629532569 | Sandra Ann Moore | Substance Abuse Rehabilitation Facility | 2632 E 17th St, Bremerton, WA 98310-5058 | 2019-01-24 |
| 1972085835 | Peninsula Counseling, LLC | Substance Abuse Rehabilitation Facility | 3214 50th Street Ct Nw Ste D-305, Gig Harbor, WA 98335-8589 | 2018-09-06 |
| 1356831911 | American Behavioral Health Systems, Inc. | Substance Abuse Rehabilitation Facility | 44 E Cozza Dr Ste B, Spokane, WA 99208-6514 | 2018-05-18 |
| 1609365238 | American Behavioral Health Systems, Inc. | Substance Abuse Rehabilitation Facility | 500 Se Adams Ave, Chehalis, WA 98532 | 2018-05-09 |
| 1588184980 | Evergreen Recovery Centers-lynnwood Detox | Substance Abuse Rehabilitation Facility | 20508 56th Ave W, Lynnwood, WA 98036 | 2017-06-27 |
| 1346785524 | Big Change Medical | Substance Abuse Rehabilitation Facility | 26857 16th Ave S, Des Moines, WA 98198-9327 | 2016-12-27 |
| 1881062362 | Sea-mar Community Health Center | Substance Abuse Rehabilitation Facility | 113 23rd Ave S, Seattle, WA 98144-2309 | 2015-09-14 |
| 1073995080 | The Haven Detox Center LLC | Substance Abuse Rehabilitation Facility | 8649 Martin Way E, Lacey, WA 98516-5812 | 2015-06-25 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT VERNON |
| Zip Code | 98273 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.