EVERGREEN MANOR (NPI# 1437587284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437587284 |
| Entity Type | Organization |
| Organization Name | EVERGREEN MANOR |
| Practice Address |
600 N 130th St Seattle WA 98133-7946 |
| Mailing Address |
Po Box 12598 Everett WA 98206-2598 |
| Practice Telephone | 2062231300 |
| Mailing Telephone | 4252582407 |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2013-10-14 |
| Authorized Official Name | LINDA GRANT (CEO) |
| Authorized Official Telephone | 4252582407 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM3000X |
Clinic/Center Specialization: Medically Fragile Intants and Children Day Care |
Ambulatory Health Care Facilities | ||
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942618889 | Evergreen Manor | Clinic/Center | 2601 Summit Ave, Everett, WA 98201-3309 | 2014-07-23 |
| 1760712400 | Evergreen Manor | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2009-12-31 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EVERGREEN MANOR | 411 W Phillip St, Rhinelander, WI 54501-3066 |
| Iowa Business Entities | EVERGREEN MANOR ASSOCIATES LIMITED PARTNERSHIP | 1909 Sycamore, Granger, IA 50109 |
| New York State Corporations | EVERGREEN MANOR DEVELOPMENT LLC | 501 Chestnut Ridge Rd Ste 306, Chestnut Ridge, Ny 10977 |
| New York State Corporations | EVERGREEN MANOR II HOMEOWNERS ASSOCIATION, INC. | 1573 Richmond Road, Staten Island, Ny 10304 |
| Washington State Corporations | EVERGREEN MANOR LLC | 5712 N Milton, Deer Park Wa, WA 99205-7169 |
| Washington State Corporations | EVERGREEN MANOR TOWNHOMES | 18551 Aurora Ave N Ste 201, Shoreline, WA 98133-3993 |
| New York State Corporations | EVERGREEN MANOR, INC. | 3101 State Route 11b, Malone, Ny 12953 |
| Colorado Business Entities | Evergreen Manor, LLC | 5006 W 8th Ave, Denver, CO 80204 |
| Oregon Corporations, Companies and Business Names | EVERGREEN MANOR, LLC | 585 Justice St Se, Salem, OR 97302 |
| System for Award Management (SAM) Entities | EVERGREEN MANORS I | 5919 Evergreen Ct, Altoona, PA 16602-1140 |
| Street Address |
600 N 130TH ST |
| City | SEATTLE |
| State | WA |
| Zip Code | 98133-7946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477644201 | Perinatal Treatment Services | Substance Abuse Rehabilitation Facility | 600 N 130th St, Seattle, WA 98133-7946 | 2006-09-27 |
| 1962933044 | Christi Proffitt | Counselor | 600 N 130th St, Seattle, WA 98133-7946 | 2017-03-21 |
| 1710426473 | Tracy Smith | Student in an Organized Health Care Education/Training Program | 600 N 130th St, Seattle, WA 98133-7946 | 2017-02-14 |
| 1215472196 | Cory Wilson | Marriage & Family Therapist | 600 N 130th St, Seattle, WA 98133-7946 | 2016-12-30 |
| 1598215600 | Mary Leblanc | Counselor | 600 N 130th St, Seattle, WA 98133-7946 | 2016-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339388 | Marni Lynn Hanig | Occupational Therapist | 1900 N 170th St., Shoreline, WA 98133 | 2019-10-29 |
| 1871074807 | Minju Kim | Counselor | 14332 Burke Ave N, Seattle, WA 98133 | 2018-08-27 |
| 1821582941 | Hana Alema Misgina | Registered Nurse | 927 N 199th St, Shoreline, WA 98133 | 2018-06-21 |
| 1588177729 | Julie Benefiel | Pharmacist | 1536 N 115th St. Suite 100, Seattle, WA 98133 | 2017-11-09 |
| 1730607953 | Aurora Oaks, LLC | Skilled Nursing Facility | 16357 Aurora Avenue North, Shoreline, WA 98133 | 2017-09-08 |
| 1750801072 | Zoe Ana Cavnar-lewandowski | Counselor | 10700 Meridian Avenue N, Suite G-11, Seattle, WA 98133 | 2017-06-27 |
| 1851820211 | Adam Lee Gardner Sr. | Acupuncturist | 925 N 163rd Street, Unit B, Shoreline, WA 98133 | 2017-06-08 |
| 1376085209 | Pamela Ashby | Counselor | 2111 N. Northgateway, 212, Seattle, WA 98133 | 2016-11-09 |
| 1225584956 | General Dentistry | Dentist | 20109 Aurora Ave N, Ste D, Shoreline, WA 98133 | 2016-09-01 |
| 1144672668 | Aaron Neubauer | Behavioral Analyst | 13407 Greenwood Ave N, 216c, Seattle, WA 98133 | 2016-07-08 |
| Find all providers in zip 98133 | ||||
| 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 |
|---|---|---|---|---|
| 1881062362 | Sea-mar Community Health Center | Substance Abuse Rehabilitation Facility | 113 23rd Ave S, Seattle, WA 98144-2309 | 2015-09-14 |
| 1518203785 | Pioneer Human Services | Substance Abuse Rehabilitation Facility | 11900 Beacon Avenue S., Seattle, WA 98178 | 2012-12-17 |
| 1760715536 | Seattle Drug and Narcotic Center Inc | Substance Abuse Rehabilitation Facility | 10344 14th Ave S, Seattle, WA 98168-1689 | 2009-09-11 |
| 1134331077 | Genesis House | Substance Abuse Rehabilitation Facility | 621 34th Ave, Seattle, WA 98122-0910 | 2007-05-04 |
| 1932252624 | Recovery Centers of King County | Substance Abuse Rehabilitation Facility | 1701 18th Ave S, Seattle, WA 98144-4317 | 2007-01-18 |
| 1215002365 | Seattle Indian Health Board | Substance Abuse Rehabilitation Facility | 9236 Renton Ave S, Seattle, WA 98118-5322 | 2006-11-22 |
| 1477644201 | Perinatal Treatment Services | Substance Abuse Rehabilitation Facility | 600 N 130th St, Seattle, WA 98133-7946 | 2006-09-27 |
| 1477010809 | Pioneer Human Services | Substance Abuse Rehabilitation Facility | 7440 W Marginal Way S, Seattle, WA 98108-4141 | 2019-02-21 |
| 1316459845 | Northbound Treatment Services of Washington, LLC | Substance Abuse Rehabilitation Facility | 510 2nd Ave W, Seattle, WA 98119-3928 | 2017-10-24 |
| 1366590770 | Sea-mar Community Health Center | Substance Abuse Rehabilitation Facility | 10001 17th Pl S, Seattle, WA 98168-1615 | 2007-01-08 |
| Find all providers in SEATTLE | ||||
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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.