EVERGREEN MANOR (NPI# 1942618889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942618889 |
| Entity Type | Organization |
| Organization Name | EVERGREEN MANOR |
| Practice Address |
2601 Summit Ave Everett WA 98201-3309 |
| Mailing Address |
Po Box 12598 Everett WA 98206-2598 |
| Practice Telephone | 4252582407 |
| Practice Fax Number | 4253392601 |
| Mailing Telephone | 4252582407 |
| Mailing Fax Number | 4253392601 |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2014-07-23 |
| Authorized Official Name | LINDA GRANT (CEO) |
| Authorized Official Telephone | 4252582407 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437587284 | Evergreen Manor | Clinic/Center | 600 N 130th St, Seattle, WA 98133-7946 | 2013-10-14 |
| 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 |
2601 SUMMIT AVE |
| City | EVERETT |
| State | WA |
| Zip Code | 98201-3309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205965159 | Evergreen Manor Detox | Substance Abuse Rehabilitation Facility | 2601 Summit Ave, Everett, WA 98201 | 2007-03-05 |
| 1023625266 | Jessica Marie Allen | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2020-09-30 |
| 1215542501 | Maya Elizabeth Caldwell Eleazer | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2020-09-13 |
| 1124645866 | Jill Marie Overton | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2020-06-29 |
| 1639798192 | Shante Monique Miller | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2020-04-14 |
| 1922638352 | Michelle Agnes Mcclory | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2020-01-24 |
| 1053941658 | Sunshine Jay Graham | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2020-01-22 |
| 1649828849 | Alexandra Rose Schmidt | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2019-08-30 |
| 1659932242 | Marie Emmanuelle Brown | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2019-06-24 |
| 1700440294 | Leslie Orr | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2019-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306471867 | Shannon Michelle Dewald | Registered Nurse | D8s 1700 13th St, Everett, WA 98201 | 2020-03-05 |
| 1578123113 | Precious Medicial Spa, LLC | Registered Nurse | 1728 W. Marine View Dr Suite 212, Everett, WA 98201 | 2019-06-17 |
| 1508429796 | Alix Deschain | Counselor | 2801 Broadway, Everett, WA 98201 | 2019-04-15 |
| 1811457534 | Khushboo Patel | Pharmacist | 1330 Rockefeller Ave Ste 150, Everett, WA 98201 | 2019-03-20 |
| 1164991188 | Grace Talbot Davis | Registered Nurse | 2601 Summit Avenue, Bldg. C, Everett, WA 98201 | 2018-11-20 |
| 1063924603 | Tracy Sisk | Counselor | 3120 Colby Ave, 502, Everett, WA 98201 | 2017-11-03 |
| 1710403126 | Michelle Durham | Counselor | 3322 Boadway Fl 2, Everett, WA 98201 | 2017-08-17 |
| 1861927949 | Melanie Schmidt | Counselor | 2610 Westmore Ave, Everett, WA 98201 | 2017-04-26 |
| 1518413327 | Joseph Madson Dmd Pllc | Clinic/Center | 3802 Colby Ave, 4th Floor, Everett, WA 98201 | 2016-08-31 |
| 1043683162 | Jennifer Adams | Counselor | 1511 26th St, Everett, WA 98201 | 2015-11-11 |
| Find all providers in zip 98201 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437648136 | American Behavioral Health Systems, Inc. | Clinic/Center | 8625 Evergreen Way Ste 100, Everett, WA 98208-2620 | 2018-05-08 |
| 1831579614 | Affordable Substance Health Services | Clinic/Center | 1316 Wall St Ste 2c, Everett, WA 98201-3942 | 2015-06-05 |
| 1124159157 | Evergreen Manor Opt Everett | Clinic/Center | 2932 Hoyt Ave, Everett, WA 98201-4003 | 2007-03-09 |
| 1174784185 | Sea-mar Community Health Center | Clinic/Center | 5007 Claremont Way, Everett, WA 98203-3321 | 2008-06-23 |
| 1669645073 | Catholic Community Services Western Washington | Clinic/Center | 2610 Wetmore Ave, Everett, WA 98201-2927 | 2008-04-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275145682 | Sea Mar Community Health Centers | Clinic/Center | 4100 194th St Sw Ste 120, Lynnwood, WA 98036-4613 | 2020-08-18 |
| 1386278372 | Social Treatment Opportunity Programs II, Inc | Clinic/Center | 600 S 1st Ave, Othello, WA 99344-1703 | 2020-02-27 |
| 1326672692 | Excelsior Integrated Care Center LLC | Clinic/Center | 3910 W. Indian Trail Rd, Spokane, WA 99208-4739 | 2020-02-26 |
| 1659919561 | Baart Behavioral Health Services, Inc. | Clinic/Center | 716 S Chase St, Port Angeles, WA 98362-6122 | 2019-12-11 |
| 1346888260 | Baart Behavioral Health Services, Inc. | Clinic/Center | 1520 Ne Riddell Rd Ste 110, Bremerton, WA 98310-3005 | 2019-12-11 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1780174441 | American Behavioral Health Systems, Inc. | Clinic/Center | 715 E Sprague Ave Ste 107, Spokane, WA 99202-2142 | 2018-05-17 |
| 1598255267 | American Behavioral Healt Systems, Inc. | Clinic/Center | 7208 267th St Nw Ste A-100, Stanwood, WA 98292-6289 | 2018-05-17 |
| 1487143350 | Steve Parker | Clinic/Center | 1206 State Ave Ste H, Marysville, WA 98270-3645 | 2018-05-07 |
| 1013444181 | Freedom Recovery, LLC | Clinic/Center | 715 E Yelm Ave Ste 6, Yelm, WA 98597-8714 | 2017-05-18 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EVERGREEN MANOR.
| 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.