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
—
—
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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