EVERGREEN PLACE (NPI# 1538287263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538287263 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PLACE |
| Practice Address |
241 Main Street Ellendale ND 58436 |
| Mailing Address |
201 8th St N Ellendale ND 58436-7341 |
| Practice Telephone | 7013494550 |
| Practice Fax Number | 7013494656 |
| Mailing Telephone | 7013494550 |
| Mailing Fax Number | 7013494656 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TONY HANSON (ADMINISTRATOR-CEO) |
| Authorized Official Telephone | 7013493312 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 30729 | ND | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 30729 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EVERGREEN PLACE | 900 W 5th Ave, Huntington, WV 25704-2800 |
| Washington State Corporations | EVERGREEN PLACE CENTER, LLC | 16420 Se Mcgillivray Blvd, Ste 103, Vancouver, WA 98683-3599 |
| Washington State Corporations | EVERGREEN PLACE INVESTORS, LLC | 41 Orcas Ky, Bellevue, WA 98006-1019 |
| Washington State Corporations | EVERGREEN PLACE MEDICAL CENTER, LLC | 2940 Fairview Avenue East, Seattle, WA 98102 |
| Vermont Business Registrations | EVERGREEN PLACE, INC. | Po Box 879, Waitsfield, VT 05673 |
| Street Address |
241 MAIN STREET |
| City | ELLENDALE |
| State | ND |
| Zip Code | 58436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063613438 | County of Dickey | Public Health or Welfare | 205 15th Street North, Ellendale, ND 58436 | 2007-05-31 |
| 1609926013 | City of Ellendale | Ambulance | 55 3rd Ave S, Ellendale, ND 58436 | 2007-01-11 |
| 1346741964 | Cotter Dental PC | Clinic/Center | 210 Main St, Ellendale, ND 58436 | 2018-02-28 |
| 1215481577 | Brandon Buckley Cotter | Dentist | 210 Main St, Ellendale, ND 58436 | 2016-08-04 |
| 1225443310 | Dakota Dental Care | Dentist | 210 Main Street, Ellendale, ND 58436 | 2014-06-26 |
| 1639246937 | Deborah J Elhard | Counselor | 240 Main St, Ellendale, ND 58436 | 2006-11-29 |
| 1477624278 | Valerie B Martin | Physician Assistant | 240 Main Street, Ellendale, ND 58436 | 2006-11-13 |
| 1760423057 | Avera St Lukes | Clinic/Center | 240 Main St, Ellendale, ND 58436 | 2006-06-09 |
| 1003928797 | Craig L Kendall | Chiropractor | 305 1st Ave S, Ellendale, ND 58436-0159 | 2006-08-31 |
| 1669686101 | Lana R. Schlecht | Dentist | 210 Main Street, Ellendale, ND 58436-0310 | 2007-05-10 |
| Find all providers in zip 58436 | ||||
| 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 |
|---|---|---|---|---|
| 1669072294 | Wp-arc Minot Holdings, LLC | Assisted Living Facility | 601 24th Ave Sw, Minot, ND 58701-7099 | 2020-11-01 |
| 1285231407 | Unsong Ringuette | Assisted Living Facility | 1608 16th St Nw, Minot, ND 58703-1114 | 2020-10-01 |
| 1295342822 | Park View Manor LLC | Assisted Living Facility | 618 8th Ave Ne, Rolla, ND 58367-7345 | 2020-09-28 |
| 1083239776 | Altru Health System | Assisted Living Facility | 4004 24th Ave S, Grand Forks, ND 58201-8863 | 2020-06-09 |
| 1437621885 | Edgewood Minot Senior Living, LLC | Assisted Living Facility | 520 28th Ave, Minot, ND 58208 | 2018-12-26 |
| 1891241139 | Edgewood Jamestown,llc | Assisted Living Facility | 322 Demers Ave, Suite 500, Grand Forks, ND 58201-4754 | 2016-08-28 |
| 1013386788 | Ecumen | Assisted Living Facility | 1405 W Gateway Cir S, Fargo, ND 58103-3529 | 2015-09-23 |
| 1306243647 | Edgewood Mandan, LLC | Assisted Living Facility | 2801 39th Ave Se, Mandan, ND 58554-6430 | 2014-12-02 |
| 1225437460 | New Town Health Support Corporation | Assisted Living Facility | 603 1st Street Nw, New Town, ND 58763 | 2014-08-13 |
| 1639501141 | Lakewood Landing, Inc. | Assisted Living Facility | 4401 21st St Se, Mandan, ND 58554 | 2013-08-07 |
| 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.