Evergreen Washington Healthcare Americana, L.L.C.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1223 Issued in WA

Legal business name

EVERGREEN WASHINGTON HEALTHCARE AMERICANA, L.L.C.

Doing business as

Americana Health and Rehabilitation Center

Practice address

917 7TH Ave
Longview, WA 98632-8632

Phone

(360) 425-5910

Fax

(360) 425-0318

NPI assigned

May 6, 2006

Organization subpart

Yes

Parent organization

EMPRES WASHINGTON HEALTHCARE, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Brent Weil

Title

Ceo and Manager

Phone

(360) 892-6628

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Americana Health and Rehabilitation Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1063461325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 NE 77TH AVE",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626736",
            "telephone_number": "360-892-6628",
            "fax_number": "360-882-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 7TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328632",
            "telephone_number": "360-425-5910",
            "fax_number": "360-425-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN WASHINGTON HEALTHCARE AMERICANA, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMPRES WASHINGTON HEALTHCARE, LLC",
        "enumeration_date": "2006-05-06",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "WEIL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "CEO AND MANAGER",
        "authorized_official_telephone_number": "360-892-6628"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4112231",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Americana Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Morgan Daneel Evans, D.O
• Sarah Ann Evans
• Evergreen Americana Health and Rehabilitation Center
• Evergreen at Park Royal II, L.L.C. (Park Royal Health and Rehabilitation Center)
• Evergreen Prosthetics and Orthotics, LLC
• Evergreen Washington Healthcare Frontier, L.L.C. (Frontier Rehabilitation and Extended Care Center)
• Evergreen Washington Healthcare Manor, L.L.C. (Evergreen Manor Health and Rehabilitation Center)
• Brandon Excell
• Kelly Anne Exner, M.A.
• John Leigh Ey, M.D.

• Skilled Nursing Facility in Longview, WA
• Providers in Longview, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.