Evergreen Manor Opt Lynwood

LBN: Evergreen Manor Opt Lynwood
Evergreen Manor Opt Lynwood is an health care organization with primary practice located at 3810 196Th St Sw 11, Lynnwood WA 98036. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder, which is considered as the primary health care specialty. Evergreen Manor Opt Lynwood can be contacted via phone (425) 248-4900, or through Grant, Linda K via phone (425) 258-2407.

Contact Information

Primary practice address
3810 196Th St Sw 11 Lynnwood WA 98036
Phone: (425) 248-4900
Fax: (425) 248-4703
Website:
Map and Directions
Authorized official contact:
Name: Grant, Linda K MS CDP
Phone: (425) 258-2407

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X 31-1336-00 Washington

Profile Details

NPI number 1689705022
LBN Legal business name Evergreen Manor Opt Lynwood
DBA Doing business as
Authorized official Grant, Linda K MS CDP
Entity Organization
Organization subpart 1 Yes
Enumeration date Mar 8th, 2007
Last updated Oct 30th, 2007 - about 19 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 1689705022 NPPES
Washington MEDICAID 1995570

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