Organization · Type 2 NPI

Evergreen at Fullerton, L.l.c.

Skilled Nursing Facility · Fullerton, CA

NPI number 1104874239 Active

Practice location

2222 N Harbor Blvd
Fullerton, CA 92835-2605

Fax (714) 526-4884

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	060000205 (CA)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

10 other providers at this address

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NPI record

NPI: 1104874239
Entity type: Organization (Type 2)
Issued: May 4, 2006
Last updated: Jan 2, 2014
Status: Active
Subpart: Yes of Empres California Healthcare, LLC

Other names

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Fullerton Post Acute Care · doing business as

Authorized official

Mr. Dale L. Patterson
Manager
(360) 892-6628

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104874239

Evergreen at Fullerton, L.l.c.'s National Provider Identifier is 1104874239, issued on May 4, 2006. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Fullerton, CA. The record was last updated on Jan 2, 2014.