Organization
EVERGREEN AT SUN CITY, L.L.C.
Active
Other names
Evergreen Sun City Health and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW V. MARTINI (MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
9940 W UNION HILLS DR, SUN CITY, AZ 85373-1673
(623) 933-0022
(623) 933-0532
Mailing address
4601 NE 77TH AVE, SUITE 300, VANCOUVER, WA 98662-6729
(360) 892-6628
(360) 882-5793
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCI-2623
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
736605
—
AZ
Enumeration date
05/04/2006
Last updated
08/22/2020
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