Evergreen Manor Detox in Everett - Substance Abuse Rehabilitation Facility
Evergreen Manor Detox - NPI 1205965159
Evergreen Manor Detox is a Substance Abuse Rehabilitation Facility in Everett, Washington. Evergreen Manor Detox practices all healthcare services and medical treatments related to Substance Abuse Rehabilitation Facility. The NPI Number for Evergreen Manor Detox is 1205965159. The last update date is 2007-10-30.
Evergreen Manor Detox'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 Detox is Po Box 12598, Everett, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Evergreen Manor Detox |
|---|---|
| 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 K Linda |
| Credentials | MS CDP |
| Telephone Number | 4252582407 |
NPI Number Detail
| NPI Number | 1205965159 |
|---|---|
| Provider Enumeration Date | 2007-03-05 |
| Last Updated Date | 2007-10-30 |
Provider Mailing Address Detail
| Address | Po Box 12598 |
|---|---|
| City | Everett |
| State | Washington (WA) |
| Post Code | 98206 |
| Phone Number | 4252582407 |
| Fax Number | 4253392601 |
Provider's Primary Taxonomy Detail
| Speciality | Substance Abuse Rehabilitation Facility |
|---|---|
| Taxonomy | 324500000X |
| Licence No | 31089100 |
|
Definition: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1994177 | WA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Evergreen Manor Detox by the Centers for Medicare & Medicaid Services (CMS)?
The Evergreen Manor Detox has been assigned the NPI (National Provider Identifier) 1205965159. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of Evergreen Manor Detox?
The Evergreen Manor Detox is situated at Po Box 12598, in the city of Everett, state of WA, with the zip code 98206.
What is Evergreen Manor Detox'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 Detox is Substance Abuse Rehabilitation Facility, and the taxonomy code that classifies this field of practice is 324500000X.
On what date did the Evergreen Manor Detox receive the assignment of its 1205965159 from the Centers for Medicare & Medicaid Services?
The Evergreen Manor Detox was issued its 1205965159 by the Centers for Medicare & Medicaid Services on 2007-03-05.
When was the information pertaining to Evergreen Manor Detox most recently updated or revised?
The details related to Evergreen Manor Detox, including its address, specialty, and other relevant information, were last updated or revised on 2007-10-30.
NPI Number: 1518960319
Address: 1655 Palm Beach Lakes Blvd Ste 300, West Palm Beach, FL
NPI Number: 1437152154
Address: One Reads Way, New Castle, DE
NPI Number: 1841293438
Address: One Reads Way, New Castle, DE
NPI Number: 1215930573
Address: 209 W Criser Rd, Front Royal, VA