| NPI | 1588184980 |
|---|---|
| Former Legal Business Name | EVERGREEN MANOR |
| Entity Type | Organization |
| Authorized Contact | LINDA K GRANT Chief Executive Officer 425-493-5310 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2017-06-27 |