NPIMap

Organization Active NPI

Evergreen Recovery Centers

  • Substance Abuse Rehabilitation Facility
  • Everett, WA
National Provider Identifier
1215067319
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
31 0108 01 Issued in WA
Legal business name
EVERGREEN RECOVERY CENTERS
Practice address
2601 Summit Ave
Everett, WA 98201
Phone
(425) 258-2407
Fax
(425) 339-2601
NPI assigned
Mar 7, 2007
Organization subpart
Yes
Parent organization
EVERGREEN MANORAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Kathy L Kain
Title
Chief Quality Officer
Phone
(425) 343-4599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 31 0108 01 WA Primary

Addresses

Primary practice location

2601 Summit Ave
Everett, WA 98201

Mailing address

PO Box 12598
Everett, WA 98206
Phone (425) 258-2407

Other identifiers 1

IdentifierTypeStateIssuer
1995133MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Recovery Centers-Health Services7 organizations share this tax ID, including this one
Part of
Evergreen Recovery Centers-Health Services

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1215067319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12598",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98206",
            "telephone_number": "425-258-2407",
            "fax_number": "425-339-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 SUMMIT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98201",
            "telephone_number": "425-258-2407",
            "fax_number": "425-339-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN RECOVERY CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERGREEN MANOR",
        "enumeration_date": "2007-03-07",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "KAIN",
        "authorized_official_first_name": "KATHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF QUALITY OFFICER",
        "authorized_official_telephone_number": "425-343-4599"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "WA",
            "license": "31 0108 01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1995133",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; 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.