Evergreen at Laurel, L.L.C.
Organization Active NPI Skilled Nursing Facility · Laurel, MT
NPI 1750339149 · NPPES record last updated Jan 30, 2017
Key facts
- NPI
- 1750339149
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 9413 (MT)
- Legal business name
- EVERGREEN AT LAUREL, L.L.C.
- Practice address
- 820 3Rd Ave
Laurel, MT 59044-2023 - Phone
- (406) 628-8251
- Fax
- (406) 628-8253
- NPI assigned
- May 5, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- EMPRES MONTANA HEALTHCARE, LLC
Authorized official
- Name
- Brent Weil
- Title
- Ceo and Manager
- Phone
- (360) 892-6628
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 9413 | MT | Yes |
Addresses
Primary practice location
820 3Rd Ave
Laurel, MT 59044-2023
Mailing address
4601 NE 77TH Ave
Suite 300
Vancouver, WA 98662-6736
Phone (360) 892-6628
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 310114 | Medicaid | MT |
Other names
- Laurel Health and Rehabilitation Center
Other providers in Laurel, MT
- Kellie A Depuydt
- Dr. Gary a. White, Optometrist, PC
- Chad Lewis Eastlick
- Edward a. Madrid, DC, PC
- Donald E Ellingson
- Dak R Fike
- Heidi Finke
- Janice Marie Fordham
- Lori Forseth
- Katlyn Ann Gotschall
All providers in Laurel, MT · Skilled Nursing Facility in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2017. 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.