Organization · Type 2 NPI

Evergreen at Petaluma, L.l.c.

Skilled Nursing Facility · Petaluma, CA

NPI number 1104874940 Active

Practice location

300 Douglas St
Petaluma, CA 94952-2503

Call (707) 763-6887 Map

Fax (707) 763-0314

Mailing address

4601 NE 77th Ave, Suite 300
Vancouver, WA 98662-6729

Specialties and licenses

TaxonomyCodeLicense
Skilled Nursing Facility Primary 314000000X010000018 (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…

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About NPI 1104874940

Evergreen at Petaluma, L.l.c.'s National Provider Identifier is 1104874940, issued on May 4, 2006. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Petaluma, CA. The record was last updated on Jan 30, 2017.