Organization · Type 2 NPI

Evergreen Idaho Healthcare Sandpoint, L.l.c.

Assisted Living Facility · Sandpoint, ID

NPI number 1891003554 Active

Practice location

624 S Division Ave
Sandpoint, ID 83864-1749

Call (208) 265-2354 Map

Fax (208) 263-8787

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility Primary	310400000X	RC-511 (ID)

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

Other assisted living facility providers in Sandpoint

Luther Park at Sandpoint, LLCAssisted Living Facility Sandpoint, ID NPI 1023743069

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NPI record

NPI: 1891003554
Entity type: Organization (Type 2)
Issued: Sep 15, 2010
Last updated: Jun 2, 2011
Status: Active
Subpart: Yes of Evergreen Idaho Healthcare, L.l.c.

Other names

<unavail>
Sandoint Assisted Living Facility · doing business as

Authorized official

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 1891003554

Evergreen Idaho Healthcare Sandpoint, L.l.c.'s National Provider Identifier is 1891003554, issued on Sep 15, 2010. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Sandpoint, ID. The record was last updated on Jun 2, 2011.