# EVERGREEN AMERICANA HEALTH AND REHABILITATION CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538154885
- **Authorized official:** JODY A. FOX (HEALTH INFORMATION MANAGER)
- **Authorized official phone:** (360) 425-5910

## Contact information

- **Practice address:** 917 7TH AVE, LONGVIEW, WA 98632-2601
- **Practice address phone:** (360) 425-5910
- **Practice address fax:** (360) 636-5935
- **Mailing address:** 917 7TH AVE, LONGVIEW, WA 98632-2601
- **Mailing address phone:** (360) 425-5910
- **Mailing address fax:** (360) 636-5935

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | WA | Yes |

## Other

- **Enumeration date:** 09/13/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4112231 | — | WA |