EVERGREEN DICKINSON, LLC (NPI# 1316143175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316143175 |
| Entity Type | Organization |
| Organization Name | EVERGREEN DICKINSON, LLC |
| Practice Address |
2143 6th Ave W Dickinson ND 58601-2700 |
| Practice Telephone | 7014836606 |
| Mailing Telephone | 7014836606 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2008-11-18 |
| Authorized Official Name | MRS. VICKIE COFER (ASST. DIRECTOR) |
| Authorized Official Telephone | 7014836606 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311Z00000X | Custodial Care Facility | 8054A | ND | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 030765 | 05 |
| Street Address |
2143 6TH AVE W |
| City | DICKINSON |
| State | ND |
| Zip Code | 58601-2700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171235 | Able Inc | Community/Behavioral Health | 1951 1st Street West, Dickinson, ND 58601 | 2020-10-15 |
| 1922626456 | Tess R Johnson, Pllc | Clinic/Center | 579 River Drive, Dickinson, ND 58601 | 2020-07-10 |
| 1295367449 | Winds of Change Counseling Services LLC | Psychologist | 30 7th St. W, Door A, Dickinson, ND 58601 | 2020-02-05 |
| 1588194351 | Nancy Wanner | Case Manager/Care Coordinator | 135 Sims Street, Suite 208, Dickinson, ND 58601 | 2017-06-14 |
| 1518332352 | Chi St. Joseph's Hospital | General Acute Care Hospital | 2500 Fairway St., Dickinson, ND 58601 | 2015-12-04 |
| 1205200359 | Jenna Weisz | Occupational Therapist | 870 Pheasant Run Ave, Dickinson, ND 58601 | 2015-11-29 |
| 1609243450 | Little Missouri Chiropractic, LLC | Chiropractor | 1462 1-94 Business Loop East, Dickinson, ND 58601 | 2015-08-27 |
| 1053799320 | Lisette Michaels | Speech-Language Pathologist | 683 State Ave N, Dickinson, ND 58601 | 2015-05-07 |
| 1336548221 | Neal Steiner | Pharmacist | 352c 1st St E, Dickinson, ND 58601 | 2014-08-18 |
| 1841607793 | Isaac Akinola | Pharmacist | 1681 Third Ave W., Dickinson, ND 58601 | 2014-07-11 |
| Find all providers in zip 58601 | ||||
| Taxonomy Code | 311Z00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. |
| Notes: Source: Paraphrased from Section 3159 A3 of the Medicare Intermediary Manual. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548803265 | The Baptist Apartments Inc Dba Prairie Pointe | Custodial Care Facility | 3330 Nebraska Dr, Bismarck, ND 58503-1663 | 2019-10-25 |
| 1295142784 | Dakota Hill Housing Corporation | Custodial Care Facility | 606 Dakota St N, Elgin, ND 58533-7157 | 2014-07-16 |
| 1518373224 | St. Anne's Guest Home | Custodial Care Facility | 524 N 17th St, Grand Forks, ND 58203-3085 | 2014-07-02 |
| 1588079156 | The Odd Fellows and Rebekah Home of North Dakota Inc. | Custodial Care Facility | 1107 Walnut St E, Devils Lake, ND 58301-3240 | 2014-06-23 |
| 1578998753 | Borg Pioneer Memorial Home | Custodial Care Facility | 61 Borg Dr, Mountain, ND 58262-6201 | 2013-09-06 |
| 1487929089 | The Leach Home | Custodial Care Facility | 714 4th St N, Wahpeton, ND 58075-3939 | 2012-03-14 |
| 1689942609 | The Evangelical Lutheran Good Samaritan Society | Custodial Care Facility | 1332 10th St Ne, Devils Lake, ND 58301-2329 | 2011-12-05 |
| 1134437932 | Golden Manor Inc | Custodial Care Facility | 214 4th Street Nw, Steele, ND 58482-7317 | 2010-09-15 |
| 1831420348 | Sanford-good Samaritan Community Health Services, LLC | Custodial Care Facility | 316 Versailles Ave, Bismarck, ND 58503-0390 | 2010-01-22 |
| 1962673608 | The Evangelical Lutheran Good Samaritan Society | Custodial Care Facility | 4502 37th Ave S, Fargo, ND 58104-7599 | 2008-03-21 |
| Find all providers with the same taxonomy | ||||
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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.