# EVERGREEN AT GRIDLEY SNF, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EVERGREEN CALIFORNIA HEALTHCARE, L.L.C.
- **Other names:** Evergreen Gridley Healthcare Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902854755
- **Legal business name:** EVERGREEN CALIFORNIA HEALTHCARE, L.L.C.
- **Authorized official:** MS. ANNE M. NIPP (MANAGER)
- **Authorized official phone:** (360) 892-6628

## Contact information

- **Practice address:** 246 SPRUCE ST, GRIDLEY, CA 95948-2216
- **Practice address phone:** (530) 846-6266
- **Practice address fax:** (530) 846-5132
- **Mailing address:** 4601 NE 77TH AVE, SUITE 300, VANCOUVER, WA 98662-6729
- **Mailing address phone:** (360) 892-6628
- **Mailing address fax:** (360) 882-5793

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 230000047 | CA | Yes |

## Other

- **Enumeration date:** 05/04/2006
- **Last updated:** 01/04/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZR18521H | — | CA |