Evergreen At Tracy, L.l.c.

NPI 1316995152 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1316995152
Enumeration Date 05/04/2006
Last Updated 02/25/2013
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name DALE L. DALE
Position MANAGER
Phone (209) 832-2273
Fax (209) 832-0743
Practice Location
2586 BUTHMANN AVE
TRACY CA, 95376-2165, US
Phone (209) 832-2273
Fax (209) 832-0743
Business Location
4601 NE 77TH AVE
SUITE 300
VANCOUVER WA, 98662-6736, US
Phone (360) 892-6628
Fax (360) 882-5793
Toxanomy
Taxonomy Code 314000000X
License State California
License Number 100000285
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According to our database, Evergreen At Tracy, L.l.c. NPI is 1316995152, taxonomy code is 314000000X and license number is 100000285, license state is located at California. Evergreen At Tracy, L.l.c. physically located at 2586 Buthmann Ave, Tracy CA, 95376-2165. NPI Number 1033115704 has the healthcare provider type.

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1316995152 NPI number is provided on an as is basis without warranty of any kind. 1316995152 is maintained by the National Plan & Provider Enumeration System. The contents of Evergreen At Tracy, L.l.c. are for informational purposes only.