Evergreen Manor - Summit Opt in Everett - Rehabilitation, Substance Use Disorder
Evergreen Manor - Summit Opt - NPI 1649453960
Evergreen Manor - Summit Opt is a Rehabilitation, Substance Use Disorder in Everett, Washington. Evergreen Manor - Summit Opt practices all healthcare services and medical treatments related to Rehabilitation, Substance Use Disorder. The NPI Number for Evergreen Manor - Summit Opt is 1649453960. The last update date is 2012-04-24.
Evergreen Manor - Summit Opt's current location address is Po Box 12598, Everett, Washington. You can contact this provider via phone number 4252582407 and fax number 4253392601. The mailing address for Evergreen Manor - Summit Opt is Po Box 12598, Everett, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Evergreen Manor - Summit Opt |
|---|---|
| Address | Po Box 12598, Everett, Washington |
| Phone Number | 4252582407 |
| Fax Number | 4253392601 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | EXECUTIVE |
|---|---|
| Authorized Official Name | Grant Linda |
| Credentials | MS CDP |
| Telephone Number | 4252582407 |
NPI Number Detail
| NPI Number | 1649453960 |
|---|---|
| Provider Enumeration Date | 2007-12-10 |
| Last Updated Date | 2012-04-24 |
Provider Mailing Address Detail
| Address | Po Box 12598 |
|---|---|
| City | Everett |
| State | Washington (WA) |
| Post Code | 982062598 |
| Phone Number | 4252582407 |
| Fax Number | 4253392601 |
Provider's Primary Taxonomy Detail
| Speciality | Rehabilitation, Substance Use Disorder |
|---|---|
| Taxonomy | 261Qr0405X |
| Licence No | 31-0108-03 |
|
Definition: Provides therapeutic interventions to treat alcohol and drug addiction. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1995620 | WA | -- |
Post Comment/ Review Below
What is the Evergreen Manor - Summit Opt's 1649453960?
The Evergreen Manor - Summit Opt's NPI (National Provider Identifier) Number is 1649453960. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Evergreen Manor - Summit Opt is physically located?
The Evergreen Manor - Summit Opt is physically situated at the following address: Po Box 12598, Everett, WA, 982062598.
What is Evergreen Manor - Summit Opt's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Evergreen Manor - Summit Opt is Rehabilitation, Substance Use Disorder, and the taxonomy code that classifies this field of practice is 261Qr0405X.
On what date did the Centers for Medicare & Medicaid Services assign the 1649453960 to Evergreen Manor - Summit Opt?
The Centers for Medicare & Medicaid Services assigned the 1649453960 to Evergreen Manor - Summit Opt on 2007-12-10.
When was the information regarding Evergreen Manor - Summit Opt most recently updated?
The details pertaining to the Evergreen Manor - Summit Opt, including its address, specialty, and other relevant information, were last refreshed on 2012-04-24.