NPI 1124767587

Evergreen Supported Living

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Bellingham, WA

Practice location

Address: 305 Flora St, Bellingham, WA 98225-4430
Phone: (360) 671-5898
Fax: (360) 922-0648

Authorised official

Name: Zay Aidan Smith McShane
Title: Executive Director
Phone: (360) 671-5898

Registered specialties (6)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

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Behavior Technician

Behavioral Health & Social Service Providers Taxonomy 106S00000X

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Case Management Agency

Agencies Taxonomy 251B00000X

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Developmentally Disabled Services Day Training Agency

Agencies Taxonomy 251C00000X

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In Home Supportive Care Agency

Agencies Taxonomy 253Z00000X

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Home Health Aide

Nursing Service Related Providers Taxonomy 374U00000X

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Registry record

NPI: 1124767587
Entity type: Organization
NPI issued: 2 Jun 2022
Record last updated: 2 Jun 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.