Organization · Type 2 NPI

Evergreen at Holladay, L.l.c.

Skilled Nursing Facility · Salt Lake City, UT

NPI number 1548218050 Active

Practice location

4600 South Highland Dr
Salt Lake City, UT 84117-5108

Call (801) 272-1892 Map

Fax (801) 274-2960

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	2005-NCF-609 (UT)

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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NPI record

NPI: 1548218050
Entity type: Organization (Type 2)
Issued: May 5, 2006
Last updated: Jan 5, 2010
Status: Active
Subpart: Yes of Evergreen Utah Healthcare, L.l.c.

Other names

<unavail>
Evergreen Canyons Health and Rehabilitation Center · doing business as

Authorized official

Ms. Anne M. Nipp
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 1548218050

Evergreen at Holladay, L.l.c.'s National Provider Identifier is 1548218050, issued on May 5, 2006. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Salt Lake City, UT. The record was last updated on Jan 5, 2010.