EVERGREEN PLACE LLC (NPI# 1487164505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487164505 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PLACE LLC |
| Practice Address |
3481 W 3100 S West Valley City UT 84119-2559 |
| Mailing Address |
Po Box 9193 Midvale UT 84047-9193 |
| Practice Telephone | 8019210070 |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-10-03 |
| Authorized Official Name | JORGE GUSTAVO GONZALEZ VILLARRUEL (OWNER) |
| Authorized Official Telephone | 8019210070 |
| Is Organization Subpart | Y |
| Parent Organization Name | 82230602 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215456777 | Evergreen Place LLC | Assisted Living Facility | 163 E 7800 S, Midvale, UT 84047-2612 | 2017-09-15 |
| 1326445388 | Evergreen Place LLC | Respite Care | 23299 285th Ave, Akeley, MN 56433-8020 | 2014-11-19 |
| Street Address |
3481 W 3100 S |
| City | WEST VALLEY CITY |
| State | UT |
| Zip Code | 84119-2559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164981932 | Arches Home Care, Inc. | Non-emergency Medical Transport (VAN) | 1385 W 2200 S Ste 203, West Valley City, UT 84119 | 2019-03-19 |
| 1629591003 | Exemplar Healthcare, Inc. | Hospice Care, Community Based | 1385 W 2200 S Ste 202, West Valley City, UT 84119 | 2017-07-18 |
| 1619358496 | Otto Bock Orthopedic Services LLC | Durable Medical Equipment & Medical Supplies | 2875 S Decker Lake Dr Ste 180, West Valley City, UT 84119 | 2015-06-17 |
| 1821407735 | Nathan William Stobbe | Dentist | 3280 W. 3500 S. Ste 3, West Valley, UT 84119 | 2014-08-05 |
| 1801209028 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3148 W 3500 S, West Valley City, UT 84119 | 2014-06-05 |
| 1215347935 | Karl Edward Jennings | Social Worker | 3901 S David Pl, West Valley City, UT 84119 | 2014-05-02 |
| 1750624672 | Shannon Quinn Dunlop | Registered Nurse | 2621 S 3270 W, West Valley City, UT 84119 | 2013-03-28 |
| 1215273529 | Holly H Tanski | Counselor | 5770 S. 1500 W. Bld A, Ihc Wasatch Canyons Campus, Salt Lake City, UT 84119 | 2012-12-14 |
| 1982955860 | Oquirrh Meadows Care and Rehab, Inc | Assisted Living Facility | 2948 So. Redwood Road, West Valley City, UT 84119 | 2012-10-02 |
| 1518235068 | Asjad Kaleem Mohammed | Pharmacist | 2290 S Redwood Road, Olive Pharmacy, Salt Lake City, UT 84119 | 2011-12-12 |
| Find all providers in zip 84119 | ||||
| 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 |
|---|---|---|---|---|
| 1982955860 | Oquirrh Meadows Care and Rehab, Inc | Assisted Living Facility | 2948 So. Redwood Road, West Valley City, UT 84119 | 2012-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689273468 | Joel C. Horne & Co., Inc. | Assisted Living Facility | 831 S 700 W Bldg B, Hurricane, UT 84737-2502 | 2020-10-22 |
| 1578160321 | Golden Horizons, LLC | Assisted Living Facility | 535 N 600 W, Richfield, UT 84701-1767 | 2020-10-05 |
| 1144835117 | Sre Asl Lindon, LLC | Assisted Living Facility | 815 W 700 N, Lindon, UT 84042-1446 | 2020-09-15 |
| 1407461460 | Sre Asl Sg, LLC | Assisted Living Facility | 2654 Red Cliffs Dr, St George, UT 84790-5827 | 2020-09-15 |
| 1992319073 | Rocky Mountain Care - Vernal Manager, LLC | Assisted Living Facility | 301 E 100 S, Vernal, UT 84078-2633 | 2020-09-04 |
| 1558988923 | Rocky Mountain Care - Lindon Manager, LLC | Assisted Living Facility | 175 N State St, Lindon, UT 84042-1813 | 2020-07-01 |
| 1689294696 | Inception Holdings | Assisted Living Facility | 3306 W 3800 S, West Valley, UT 84119-4431 | 2020-04-20 |
| 1841828803 | Mg Cottonwood Heights Subtenant LLC | Assisted Living Facility | 7235 S Union Park Ave, Cottonwood Heights, UT 84047-4700 | 2020-03-27 |
| 1558993337 | Holladay Home Assisted Living LLC | Assisted Living Facility | 5950 S Highland Dr, Holladay, UT 84121-1328 | 2020-02-10 |
| 1740811223 | A Level Ventures | Assisted Living Facility | 940 N 2335 W, Vernal, UT 84078-8300 | 2020-02-03 |
| Find all providers with the same taxonomy | ||||
| City | WEST VALLEY CITY |
| Zip Code | 84119 |
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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.