EVERGREEN SENIOR LIVING,INC (NPI# 1073919783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073919783 |
| Entity Type | Organization |
| Organization Name | EVERGREEN SENIOR LIVING,INC |
| Practice Address |
23635 Collins St Woodland Hills CA 91367-5916 |
| Practice Telephone | 8183312320 |
| Practice Fax Number | 8187047339 |
| Mailing Telephone | 8183312320 |
| Mailing Fax Number | 8187047339 |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2014-11-06 |
| Authorized Official Name | MR. JACOB FAHIMIPOUR (ADMINISTRATOR) |
| Authorized Official Telephone | 8183312320 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 197608576 | CA | Nursing & Custodial Care Facilities |
| Street Address |
23635 COLLINS ST |
| City | WOODLAND HILLS |
| State | CA |
| Zip Code | 91367-5916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912316365 | Jacob Fahimipour | Community Health Worker | 23635 Collins St, Woodland Hills, CA 91367-5916 | 2014-08-11 |
| 1053931311 | Silver Care Inc | Skilled Nursing Facility | 23635 Collins St, Woodland Hills, CA 91367-5916 | 2020-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144837386 | Welby Way Home LLC | Hospice Care, Community Based | 21550 Oxnard St., 3rd Floor Suite # 57, Woodland Hills, CA 91367 | 2020-09-30 |
| 1821619180 | Jmg Recovery, Inc | Substance Abuse Rehabilitation Facility | 23043 Hatteras Street, Woodland Hills, CA 91367 | 2020-04-28 |
| 1952952137 | Carol L. Frankel | Technician | 22616 Victory Blvd., Woodland Hills, CA 91367 | 2019-09-27 |
| 1346890191 | Sharie Renell Boudreaux | Behavioral Analyst | 210600 Oxnard St, Suite 1800, Woodland Hills, CA 91367 | 2019-09-13 |
| 1104381631 | Victor Fernando Tovar | Behavior Technician | 21600 Oxnard Street, Suite 1030, Woodland Hills, CA 91367 | 2019-02-08 |
| 1982173076 | Tefany Cheam | Behavioral Analyst | 216000 Oxnard St., Suite 1800, Woodland Hills, CA 91367 | 2018-11-19 |
| 1205301520 | Basso Pharmacy, Inc. | Pharmacy | 5952 & 5954 Fallbrook Avenue, Woodland Hills, CA 91367 | 2018-10-13 |
| 1255813523 | Annemarie Fine | Behavioral Analyst | 21609 Oxnard St Ste 1800, Woodland Hills, CA 91367 | 2018-09-04 |
| 1730661166 | Paige Sefton | Marriage & Family Therapist | 21333 Oxnard St., Woodland Hills, CA 91367 | 2018-09-01 |
| 1073095402 | Rosalia Hernandez | Behavioral Analyst | 21600 Oxnard St Ste, Woodland Hills, CA 91367 | 2018-09-01 |
| Find all providers in zip 91367 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670904 | Bewise | Assisted Living Facility | 22214 Vanowen St, Woodland Hills, CA 91303-2401 | 2019-10-14 |
| 1992271472 | Liliya Pyarali | Assisted Living Facility | 5515 Fallbrook Ave, Woodland Hills, CA 91367-4327 | 2018-10-22 |
| 1770761363 | E D Gardens Inc. | Assisted Living Facility | 23601 Canzonet St, Woodland Hills, CA 91367-5845 | 2008-02-06 |
| 1942773361 | Reseda Home for The Elderly, Inc. - Dba- Ave of The Bells | Assisted Living Facility | 5826 Jumilla Ave, Woodland Hills, CA 91367-5604 | 2019-01-08 |
| 1801384631 | Ventura Park Management LLC | Assisted Living Facility | 21200 Ventura Blvd, Woodland Hills, CA 91364-2106 | 2018-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588165 | Nana's Garden II | Assisted Living Facility | 25312 Ericson Way, Laguna Hills, CA 92653-5054 | 2020-11-03 |
| 1609476589 | Southbay Care Home, Inc. | Assisted Living Facility | 19917 Anza Avenue, Torrance, CA 90503-2005 | 2020-10-29 |
| 1821697434 | Global Regency Senior Care Services, LLC | Assisted Living Facility | 117 E 8th St, Long Beach, CA 90813-4397 | 2020-10-23 |
| 1689273419 | Pacifica Slo LLC | Assisted Living Facility | 475 Marsh St, San Luis Obispo, CA 93401-6108 | 2020-10-22 |
| 1871192682 | Pacifica Sfo LLC | Assisted Living Facility | 624 Laguna St, San Francisco, CA 94102-4217 | 2020-10-22 |
| 1528667367 | Pacifica Sierra Vista Lp | Assisted Living Facility | 13815 Rodeo Dr, Victorville, CA 92395-5600 | 2020-10-22 |
| 1992304737 | West Lyons Lp | Assisted Living Facility | 24305 Lyons Ave, Newhall, CA 91321-2344 | 2020-10-22 |
| 1619576451 | Pacifica Orange County LLC | Assisted Living Facility | 2619 Orange Ave, Costa Mesa, CA 92627-4630 | 2020-10-22 |
| 1720687551 | P San Leandro Lp | Assisted Living Facility | 348 W Juana Ave, San Leandro, CA 94577-3661 | 2020-10-22 |
| 1952900730 | Pacifica Daly LLC | Assisted Living Facility | 995 E Market St, Daly City, CA 94014-2168 | 2020-10-22 |
| Find all providers with the same taxonomy | ||||
| City | WOODLAND HILLS |
| Zip Code | 91367 |
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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.