Evergreen Nursing and Rehabilitation Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

128590 Issued in TX

Legal business name

EVERGREEN NURSING AND REHABILITATION CENTER, LLC

Practice address

1110 Westview Dr
Seymour, TX 76380-3965

Phone

(940) 889-3176

Fax

(940) 889-8806

NPI assigned

Jan 21, 2010

Organization subpart

No

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

Authorized official

Name

Sidney Pinter

Title

Member

Phone

(718) 535-3801

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1972834539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 AVENUE L",
            "address_2": "SUITE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305114",
            "telephone_number": "718-535-3801",
            "fax_number": "718-338-1019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 WESTVIEW DR",
            "city": "SEYMOUR",
            "state": "TX",
            "postal_code": "763803965",
            "telephone_number": "940-889-3176",
            "fax_number": "940-889-8806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN NURSING AND REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "PINTER",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-535-3801"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "128590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001014747",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rance Carrington, R.T. (R)
• Toni Hsi Hao Chu, MD
• David a Awalt
• Chris J Deges, RPH
• Jennifer Elliott, MSN, APRN, FNP-BC
• Grace Care of Texas
• Grace Care of Texas, Inc.
• Healthcare Management Partners of Dallas, LLC
• Home Health of Rural Texas, Inc.
• Larry Howard, PA

• Skilled Nursing Facility in Seymour, TX
• Providers in Seymour, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; 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.