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Organization
EVERGREEN AT ELY, L.L.C.
Active
Organization
EVERGREEN AT ELY, L.L.C.
Active
Other names
White Pine Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ROBERT PREIMESBERGER (MANAGER)
(213) 220-4808
Entity
Organization
Contact information
Practice address
1500 AVENUE G, ELY, NV 89301-2539
(775) 289-8801
(775) 289-3208
Mailing address
1500 AVENUE G, ELY, NV 89301-2539
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1917920
—
NV
Enumeration date
06/05/2020
Last updated
06/05/2020
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