Evergreen at Missoula, L.L.C.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EVERGREEN AT MISSOULA, L.L.C.

Doing business as

Missoula Health and Rehabilitation Center

Practice address

3018 Rattlesnake Dr
Missoula, MT 59802-6101

Phone

(406) 549-0988

Fax

(406) 549-0111

NPI assigned

Jul 26, 2016

Last updated

Feb 1, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

EMPRES MONTANA 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

Manager

Phone

(360) 892-6628

Specialties & licenses 4

Addresses

Other names 1

• Missoula Health and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485907200000",
    "number": "1447703533",
    "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": "986626729",
            "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": "3018 RATTLESNAKE DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598026101",
            "telephone_number": "406-549-0988",
            "fax_number": "406-549-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN AT MISSOULA, L.L.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EMPRES MONTANA HEALTHCARE, LLC",
        "enumeration_date": "2016-07-26",
        "last_updated": "2017-02-01",
        "status": "A",
        "authorized_official_last_name": "WEIL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-892-6628"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MT",
            "license": "13184",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MT",
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MT",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MT",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Missoula Health and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elliott Margaret Evans, SWLC
• Kenneth D Evans
• Nancy L Everett, CNM
• Skye Kendall Everett, DPT
• Wade A Everett
• Evergreen at Missoula, L.L.C. (Missoula Health and Rehabilitation Center)
• Kimberly Everingham, OD
• Evernorth Care Providers - Arizona PC
• Kiley S Eversole
• Every Voice Speech Therapy

• Assisted Living Facility in Missoula, MT
• Providers in Missoula, MT by specialty
• Assisted Living Facility in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.