EVERGREEN AT HOLLADAY, L.L.C. (NPI# 1548218050) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548218050 |
| Entity Type | Organization |
| Organization Name | EVERGREEN AT HOLLADAY, L.L.C. |
| Other Organization Name | EVERGREEN CANYONS HEALTH AND REHABILITATION CENTER |
| Practice Address |
4600 South Highland Dr Salt Lake City UT 84117-5108 |
| Mailing Address |
4601 Ne 77th Ave Suite 300 Vancouver WA 98662-6729 |
| Practice Telephone | 8012721892 |
| Practice Fax Number | 8012742960 |
| Mailing Telephone | 3608926628 |
| Mailing Fax Number | 3608825793 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2010-01-05 |
| Authorized Official Name | MS. ANNE M. NIPP (MANAGER) |
| Authorized Official Telephone | 3608926628 |
| Is Organization Subpart | Y |
| Parent Organization Name | EVERGREEN UTAH HEALTHCARE, L.L.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 2005-NCF-609 | UT | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Evergreen Canyons Health and Rehabilitation Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EVERGREEN AT HOLLADAY, L.L.C. | 4601 Ne 77th Ave Ste 300, Vancouver, WA 98662 |
| Street Address |
4600 SOUTH HIGHLAND DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84117-5108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063052256 | Abundant Dental Care, P.C. | Dentist | 1548 E 4500 S #104, Holladay, UT 84117 | 2020-01-15 |
| 1578127221 | Signature Utah Dental Partners PC | Clinic/Center | 2240 E Murray Holladay Rd, Holladay, UT 84117 | 2019-04-29 |
| 1700392974 | Marette Monson, LLC | Community/Behavioral Health | 2180 East 4500 South, Suite 105, Holladay City, UT 84117 | 2017-12-23 |
| 1942714639 | Harmon City Inc | Pharmacy | 4675 South Holladay Blvd, Holladay, UT 84117 | 2017-11-17 |
| 1881119444 | Brianna Stewart | Physical Medicine & Rehabilitation | 5151 South 900 East, Suite 100, Salt Lake City, UT 84117 | 2017-08-04 |
| 1861842874 | Whitney Aste | Dentist | 1548 E 4500 S Ste 104, Salt Lake City, UT 84117 | 2016-06-21 |
| 1922403765 | Tri-peak, Pllc | Psychologist | 4535 S 2300 E, Suite B, Salt Lake City, UT 84117 | 2014-10-22 |
| 1356689566 | Mckenzie Vierig | Marriage & Family Therapist | 4568 S Highland Dr Ste 380, Millcreek, UT 84117 | 2013-01-22 |
| 1821348640 | Fabiola Marquez Jamieson | Social Worker | 4500 S 2180 E, Suite 165, Holladay, UT 84117 | 2012-09-19 |
| 1073882882 | Amy Rose White | Social Worker | 4500 South 2180 East, Suite 165, Holladay, UT 84117 | 2011-12-22 |
| Find all providers in zip 84117 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962955237 | Beaver Valley Hospital | Skilled Nursing Facility | 4782 S Holladay Blvd, Salt Lake City, UT 84117-5444 | 2016-08-03 |
| 1902130222 | Beaver Valley Hospital | Skilled Nursing Facility | 2200 East 3300 South, Salt Lake City, UT 84109 | 2009-09-21 |
| 1598990699 | Beaver Valley Hospital | Skilled Nursing Facility | 4600 S. Highland Drive, Salt Lake City, UT 84117 | 2009-05-19 |
| 1629129689 | Subtenant 1430 East 4500 South LLC | Skilled Nursing Facility | 1430 East 4500 South, Salt Lake City, UT 84117-4208 | 2007-01-16 |
| 1760594048 | Utah State Veterans Nursing Home | Skilled Nursing Facility | 700 Foothill Blvd, Salt Lake City, UT 84113-1104 | 2006-08-31 |
| 1225061229 | Salt Lake Operations, LLC | Skilled Nursing Facility | 1201 E 4500 S, Salt Lake City, UT 84117-4124 | 2006-07-10 |
| 1679526156 | Sunrise Senior Living Services, Inc | Skilled Nursing Facility | 76 S 500 E, Salt Lake City, UT 84102-1044 | 2006-05-18 |
| 1326098039 | Eagles Soar Inc. | Skilled Nursing Facility | 433 E 2700 S, Salt Lake City, UT 84115-3325 | 2006-05-11 |
| 1457338956 | Mission Health Services | Skilled Nursing Facility | 1216 E 1300 S, Salt Lake City, UT 84105-1949 | 2005-12-27 |
| 1700862380 | Arlington Hill Care Center | Skilled Nursing Facility | 165 S 1000 E, Salt Lake City, UT 84102-1402 | 2005-12-15 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84117 |
Please comment or provide details below to improve the information on EVERGREEN AT HOLLADAY, L.L.C..
| 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.