Evergreen Residence

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

3275AGC-6 Issued in NV

Legal business name

EVERGREEN RESIDENCE

Practice address

1305 Kings CT
Reno, NV 89503-3521

Phone

(775) 787-9520

Fax

(775) 747-7417

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Amei Woo

Title

Administrator

Phone

(775) 787-9520

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1467519538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 KINGS CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895033521",
            "telephone_number": "775-787-9520",
            "fax_number": "775-747-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 KINGS CT",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895033521",
            "telephone_number": "775-787-9520",
            "fax_number": "775-747-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN RESIDENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "WOO",
        "authorized_official_first_name": "AMEI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "775-787-9520",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NV",
            "license": "3275AGC-6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005716003",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Lee Evans, PA
• Frank Evarts, PH.D.
• Denise Lucille Everett, MFT
• Roslein Everett, D.O.
• Evergreen Recidences
• Everside Health-Reno
• Evolve Psychiatry PLLC
• Evolve Wellness and Medical Collective
• Evolved Incorporated (Evolve Chiropractic Boutique)
• Connie S Ewing

• Assisted Living Facility in Reno, NV
• Providers in Reno, NV by specialty
• Assisted Living Facility in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.