NPI 1083662514 · live from the CMS NPI Registry
Evergreen At Gardnerville, L.L.C.
Skilled Nursing Facility in Gardnerville, NV. National Provider Identifier 1083662514, active.
NPI record
| NPI | 1083662514 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 1573 Muller Pkwy, Gardnerville, NV 89410 |
| Practice phone | 775-782-6620 |
| Mailing address | 4601 Ne 77th Ave, Suite 300, Vancouver, WA 98662 |
| Enumerated | May 5, 2006 |
| Last updated | February 1, 2022 |
| Authorized official | Michael Miller, Cfo And Assistant Manager |
| Other names | Gardnerville Health & Rehab Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Occupational Therapist | 225X00000X | — |
| Speech-Language Pathologist, | 235Z00000X | — |
| Skilled Nursing Facility primary | 314000000X | 3995SNF-5 (NV) |
| Physical Therapist | 225100000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.