<Unavail>

LBN: Evergreen Kitsap, L.L.C.
<Unavail> is an health care organization with primary practice located at 3517 11Th St , Bremerton WA 98312-2633. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Evergreen Kitsap, L.L.C. can be contacted via phone (360) 377-5537, or through Patterson, Dale L. via phone (360) 892-6628.

Contact Information

Primary practice address
3517 11Th St Bremerton WA 98312-2633
Phone: (360) 377-5537
Fax: (360) 405-0537
Website:
Map and Directions
Authorized official contact:
Name: Patterson, Dale L.
Phone: (360) 892-6628

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 1367 Washington

Profile Details

NPI number 1770578791
LBN Legal business name Evergreen Kitsap, L.L.C.
DBA Doing business as <Unavail>
Authorized official Patterson, Dale L.
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 15th, 2005
Last updated Jun 3rd, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770578791 NPPES
Washington Other 1367 STATE NURSING HOME NUMBER
Washington MEDICAID 4111407 STATE NURSING HOME NUMBER

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