Organization
EVERGREEN AT SHELTON, L.L.C.
Active
Parent organization
EMPRES WASHINGTON HEALTHCARE, LLC
Other names
Shelton Health and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
EMPRES WASHINGTON HEALTHCARE, LLC
Authorized official
MICHAEL J. MILLER (CEO AND MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
153 JOHNS CT, SHELTON, WA 98584-8225
(360) 427-2575
(360) 427-2563
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
1324
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4113247
—
WA
Enumeration date
05/04/2006
Last updated
02/03/2022
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