NPI 1083662514

Evergreen at Gardnerville, L.L.C.

Organisation Skilled Nursing Facility Gardnerville, NV

Practice location

Address: 1573 Muller Pkwy, Gardnerville, NV 89410-7918
Phone: (775) 782-6620
Fax: (775) 782-6945
Mailing address: 4601 NE 77th Ave Suite 300, Vancouver, WA 98662-6736

Authorised official

Name: Michael J. Miller
Title: Cfo and Assistant Manager
Phone: (360) 892-6628

Registered specialties (4)

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence 3995SNF-5 (NV)

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Physical Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X

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Occupational Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225X00000X

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Speech-Language Pathologist

Speech, Language and Hearing Service Providers Taxonomy 235Z00000X

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Registry record

NPI: 1083662514
Entity type: Organization
NPI issued: 5 May 2006
Record last updated: 1 Feb 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.