Organization
EVERGREEN AT HOLLADAY, L.L.C.
Active
Parent organization
EVERGREEN UTAH HEALTHCARE, L.L.C.
Other names
Evergreen Canyons Health and Rehabilitation Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVERGREEN UTAH HEALTHCARE, L.L.C.
Authorized official
MS. ANNE M. NIPP (MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
4600 SOUTH HIGHLAND DR, SALT LAKE CITY, UT 84117-5108
(801) 272-1892
(801) 274-2960
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
2005-NCF-609
UT
Other
Enumeration date
05/05/2006
Last updated
01/05/2010
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