Organization
EVERGREEN AT GRIDLEY SNF, L.L.C.
Active
Parent organization
EVERGREEN CALIFORNIA HEALTHCARE, L.L.C.
Other names
Evergreen Gridley Healthcare Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVERGREEN CALIFORNIA HEALTHCARE, L.L.C.
Authorized official
MS. ANNE M. NIPP (MANAGER)
(360) 892-6628
Entity
Organization
Contact information
Practice address
246 SPRUCE ST, GRIDLEY, CA 95948-2216
(530) 846-6266
(530) 846-5132
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
230000047
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZR18521H
—
CA
Enumeration date
05/04/2006
Last updated
01/04/2010
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