Organization
EVERGREEN AT TRACY, L.L.C.
Active
Parent organization
EMPRES CALIFORNIA HEALTHCARE, LLC
Other names
New Hope Post Acute Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
EMPRES CALIFORNIA HEALTHCARE, LLC
Authorized official
BRENT WEIL (CEO AND MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
2586 BUTHMANN AVE, TRACY, CA 95376-2165
(209) 832-2273
(209) 832-0743
Mailing address
4601 NE 77TH AVE, SUITE 300, VANCOUVER, WA 98662-6736
(360) 892-6628
(360) 882-5793
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100000285
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC55245I
—
CA
Enumeration date
05/04/2006
Last updated
01/30/2017
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