EVERGREEN WASHINGTON HEALTHCARE FRONTIER, L.L.C. (NPI# 1104811207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104811207 |
| Entity Type | Organization |
| Organization Name | EVERGREEN WASHINGTON HEALTHCARE FRONTIER, L.L.C. |
| Other Organization Name | FRONTIER REHABILITATION AND EXTENDED CARE CENTER |
| Practice Address |
1500 3rd Ave Longview WA 98632-8632 |
| Mailing Address |
4601 Ne 77th Ave Suite 300 Vancouver WA 98662-6736 |
| Practice Telephone | 3604238800 |
| Practice Fax Number | 3606363421 |
| Mailing Telephone | 3608926628 |
| Mailing Fax Number | 3608825793 |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2017-01-30 |
| Authorized Official Name | BRENT WEIL (CEO AND MANAGER) |
| Authorized Official Telephone | 3608926628 |
| Is Organization Subpart | Y |
| Parent Organization Name | EMPRES WASHINGTON HEALTHCARE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 1225 | WA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | STATE NH# | 1225 | 01 |
| WA | 4112256 | 05 |
| Other Name | Type Code |
|---|---|
| Frontier Rehabilitation and Extended Care Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EVERGREEN WASHINGTON HEALTHCARE FRONTIER, L.L.C. | 1500 3rd Ave, Longview, WA 98632-3229 |
| Street Address |
1500 3RD AVE |
| City | LONGVIEW |
| State | WA |
| Zip Code | 98632-8632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659857175 | Alyssa K Thornton | Speech-Language Pathologist | 1500 3rd Ave, Longview, WA 98632-3229 | 2018-07-18 |
| 1861904054 | Emma Marie Shaffer | Physical Medicine & Rehabilitation | 1500 3rd Ave, Longview, WA 98632-3229 | 2017-10-29 |
| 1427569904 | John Overton | Occupational Therapy Assistant | 1500 3rd Ave, Longview, WA 98632-3229 | 2017-10-23 |
| 1902336183 | Amber Humphrey | Speech-Language Pathologist | 1500 3rd Ave, Longview, WA 98632-3229 | 2017-06-19 |
| 1740738970 | Andrea Katherine Koueiter | Physical Therapist | 1500 3rd Ave, Longview, WA 98632-3229 | 2016-09-16 |
| 1306273743 | Kristin Lidvall | Specialist | 1500 3rd Ave, Longview, WA 98632-3229 | 2013-09-30 |
| 1487991428 | Joshua Douglas Kennedy | Physical Therapy Assistant | 1500 3rd Ave, Longview, WA 98632-3229 | 2013-01-10 |
| 1720322191 | Christina Mason | Physical Therapy Assistant | 1500 3rd Ave, Longview, WA 98632-3229 | 2012-11-24 |
| 1689952194 | Dawn Danielle Belding-wilson | Occupational Therapist | 1500 3rd Ave, Longview, WA 98632-3229 | 2011-08-01 |
| 1144543752 | Elvina Irene Taylor | Occupational Therapist | 1500 3rd Ave, Longview, WA 98632-3229 | 2010-03-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992366 | Honor Senior Care LLC | Home Health Aide | 1135 3rd Ave, Ste S101, Longview, WA 98632 | 2020-11-03 |
| 1417416728 | Sam Wise | Dentist | 1538 11th Ave Lowr Columbia, Longview, WA 98632 | 2019-03-16 |
| 1053870717 | Matthew Johnson | Physician Assistant | 900 Ocean Beach Hwy Ste 110, Longview, WA 98632 | 2019-03-12 |
| 1295205367 | Abid Valji | Occupational Therapist | Americana Health and Rehabilitation Center, 917 7th Ave, Longview, WA 98632 | 2018-11-30 |
| 1184106437 | Peacehealth | Durable Medical Equipment & Medical Supplies | Triangle Mall Suite 16 1015 Ocean Beach Hwy, Longview, WA 98632 | 2018-09-04 |
| 1982186318 | Linda Joan Mason | Licensed Practical Nurse | 1153 23rd Ave, Longview, WA 98632 | 2018-09-01 |
| 1891291910 | Ellen Sumner Hornbeak | Physical Therapist | 200 Triangle Shopping Ctr Ste 270, Longview, WA 98632 | 2018-04-05 |
| 1700399961 | Johnna Joyce Knapp | Speech-Language Pathologist | 2615 Lilac St, Longview, WA 98632 | 2017-11-09 |
| 1841711868 | Deborah Annette Burzynski | Registered Nurse | 1057 12th Avenue, Longview, WA 98632 | 2017-06-29 |
| 1598291122 | Cheyenne West | Counselor | 1616 10th Avenue, Longview, WA 98632 | 2017-05-02 |
| Find all providers in zip 98632 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | 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 reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659756047 | Gruenepointe 1 Longview, LLC | Skilled Nursing Facility | 2131 Alpine Rd, Longview, TX 75601-3402 | 2015-07-27 |
| 1861818635 | Hopkins County Hospital District | Skilled Nursing Facility | 1154 E Hawkins Pkwy, Longview, TX 75605-7975 | 2014-03-17 |
| 1689840266 | Legacy Healthcare Services, Inc. | Skilled Nursing Facility | 1517 Edna Ln, Longview, TX 75602-4915 | 2008-05-05 |
| 1063571552 | Buckner Retirement Services, Inc | Skilled Nursing Facility | 2201 Horseshoe Ln, Longview, TX 75605-5650 | 2006-12-08 |
| 1487600706 | Hopkins County Hospital District | Skilled Nursing Facility | 3201 4th St, Longview, TX 75605-5145 | 2006-05-26 |
| 1750335345 | Linderian Company, Ltd | Skilled Nursing Facility | 301 Hollybrook Dr, Longview, TX 75605-2461 | 2006-05-19 |
| 1437117272 | Longview I Enterprises, LLC | Skilled Nursing Facility | 2711 Pine Tree Rd, Longview, TX 75604-1646 | 2006-05-02 |
| 1659337384 | Whispering Pines Lodge Illp | Skilled Nursing Facility | 2131 Alpine Road, Longview, TX 75601 | 2006-04-21 |
| 1437125937 | Clairmont Longview, Lp | Skilled Nursing Facility | 3201 N 4th St, Longview, TX 75605-5145 | 2006-02-24 |
| 1578551768 | Highland Pines Nursing Home, Ltd | Skilled Nursing Facility | 1100 N 4th St, Longview, TX 75601-4739 | 2005-10-11 |
| Find all providers in LONGVIEW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.