Organization
EVERGREEN AMERICANA HEALTH AND REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JODY A. FOX (HEALTH INFORMATION MANAGER)
(360) 425-5910
Entity
Organization
Contact information
Practice address
917 7TH AVE, LONGVIEW, WA 98632-2601
(360) 425-5910
(360) 636-5935
Mailing address
917 7TH AVE, LONGVIEW, WA 98632-2601
(360) 425-5910
(360) 636-5935
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4112231
—
WA
Enumeration date
09/13/2005
Last updated
08/22/2020
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