Evergreen at Gardnerville, L.L.C.
Organization Active NPI Skilled Nursing Facility · Gardnerville, NV
NPI 1083662514 · NPPES record last updated Feb 1, 2022
Key facts
- NPI
- 1083662514
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 3995SNF-5 (NV)
- Legal business name
- EVERGREEN AT GARDNERVILLE, L.L.C.
- Practice address
- 1573 Muller Pkwy
Gardnerville, NV 89410-7918 - Phone
- (775) 782-6620
- Fax
- (775) 782-6945
- NPI assigned
- May 5, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- EMPRES NEVADA HEALTHCARE, LLC
Authorized official
- Name
- Michael J. Miller
- Title
- Cfo and Assistant Manager
- Phone
- (360) 892-6628
Practitioners 1
-
Aleli Favila Rojas, M.D.
National Provider Directory
Locations
1565 Virginia Ranch Rd
Gardnerville, NV 89410
Phone (775) 309-4860
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
235Z00000X | |||
| Skilled Nursing Facility | 314000000X | 3995SNF-5 | NV | Yes |
Addresses
Primary practice location
1573 Muller Pkwy
Gardnerville, NV 89410-7918
Mailing address
4601 NE 77TH Ave
Suite 300
Vancouver, WA 98662-6736
Phone (360) 892-6628
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100503498 | Medicaid | NV |
Other names
- Gardnerville Health & Rehab Center
Other providers in Gardnerville, NV
- Thomas J Embree
- Equanimity Counseling and Psychological Services
- Regina Eramaa
- Eric S. Park, DDS, PC
- Elizabeth Ann Eubanks
- Family Support Council of Douglas County
- Family Support Council of Douglas County
- Carmella Feazel
- Rebecca Finch
- Michael Edward Fischer
All providers in Gardnerville, NV · Skilled Nursing Facility in Nevada
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.