Evergreen Manor - Residential 2

NPI 1093998312 - Substance Abuse Rehabilitation Facility - 324500000X

NPI Details
NPI 1093998312
Enumeration Date 12/10/2007
Last Updated 12/10/2007
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name LINDA LINDA
Position EXECUTIVE DIRECTOR
Phone (425) 258-2407
Fax (425) 339-2601
Practice Location
2601 SUMMIT AVE
EVERETT WA, 98201-3309, US
Phone (425) 258-2407
Fax (425) 339-2601
Business Location
PO BOX 12598
EVERETT WA, 98206-2598, US
Phone (425) 258-2407
Fax (258) 339-2601
Toxanomy
Taxonomy Code 324500000X
License State Washington
License Number 31-0108-02
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According to our database, Evergreen Manor - Residential 2 NPI is 1093998312, taxonomy code is 324500000X and license number is 31-0108-02, license state is located at Washington. Evergreen Manor - Residential 2 physically located at 2601 Summit Ave, Everett WA, 98201-3309. NPI Number 1033115704 has the healthcare provider type.

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1093998312 NPI number is provided on an as is basis without warranty of any kind. 1093998312 is maintained by the National Plan & Provider Enumeration System. The contents of Evergreen Manor - Residential 2 are for informational purposes only.