EVERGREEN HOSPICE LLC (NPI# 1518301902) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518301902 |
| Entity Type | Organization |
| Organization Name | EVERGREEN HOSPICE LLC |
| Practice Address |
1355 N Main St Ste 11 Bountiful UT 84010-5982 |
| Mailing Address |
1355 N Main Street, Ste 11 Evergreen Hospice Dba Renew Home Health & Hospice Bountiful UT 84010-5982 |
| Practice Telephone | 8013644250 |
| Practice Fax Number | 8019941278 |
| Mailing Telephone | (801) 364-4250 |
| Mailing Fax Number | 8019941278 |
| Enumeration Date | 2013-04-29 |
| Last Update Date | 2017-09-12 |
| Authorized Official Name | MRS. STEPHANIE BEAR (OFFICE MANAGER) |
| Authorized Official Telephone | 4357532438 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251G00000X | Hospice Care, Community Based | 2013-HOSPICE-UT0 | UT | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740339548 | Evergreen Hospice LLC | Hospice Care, Community Based | 9902 E 43rd St, Suite B, Tulsa, OK 74146-4756 | 2007-01-09 |
| Street Address |
1355 N MAIN ST STE 11 |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-5982 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104135250 | Renew Home Health Inc | Home Health | 1355 N Main St Ste 11, Bountiful, UT 84010-5982 | 2010-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
| 1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
| 1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
| 1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
| 1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
| 1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
| 1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
| 1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
| 1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
| 1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
| Find all providers in zip 84010 | ||||
| Taxonomy Code | 251G00000X |
| Grouping | Agencies |
| Classification | Hospice Care, Community Based |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447728514 | Home Health Partner Services, LLC | Hospice Care, Community Based | 415 Medical Dr Ste A101, Bountiful, UT 84010-4995 | 2018-11-07 |
| 1427480714 | Squire Boys, Inc. | Hospice Care, Community Based | 415 Medical Dr Ste C102, Bountiful, UT 84010-8902 | 2013-08-08 |
| 1538413489 | Adagio Hospice LLC | Hospice Care, Community Based | 845 S Main St Ste C6, Bountiful, UT 84010-6482 | 2012-10-30 |
| 1407082787 | Broadway Investments LLC | Hospice Care, Community Based | 503 W 2600 S Ste 200, Bountiful, UT 84010-7717 | 2009-06-01 |
| 1154339265 | Family First Hospice | Hospice Care, Community Based | 506 S Main St Ste 303, Bountiful, UT 84010-6311 | 2006-08-04 |
| 1215970835 | Providential Bba Operating Lp | Hospice Care, Community Based | 481 South 400 East, Bountiful, UT 84010-8401 | 2006-06-13 |
| 1497295752 | Unified Health Services, LLC | Hospice Care, Community Based | 415 Medical Dr Ste A100, Bountiful, UT 84010-4995 | 2017-03-06 |
| 1447694138 | Everest Home Health and Hospice | Hospice Care, Community Based | 845 S Main St, Suite 7a, Bountiful, UT 84010-6381 | 2013-04-24 |
| 1235470337 | Independence Home Care | Hospice Care, Community Based | 640 S. 500 W., Bountiful, UT 84010-7210 | 2013-03-14 |
| 1558627273 | Tlc Hospice | Hospice Care, Community Based | 503 W 2600 S Ste 200, Bountiful, UT 84010-7717 | 2012-04-06 |
| Find all providers in BOUNTIFUL | ||||
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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.