EVERGREEN RECOVERY CENTER (NPI# 1578008462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578008462 |
| Entity Type | Organization |
| Organization Name | EVERGREEN RECOVERY CENTER |
| Practice Address |
2601 Summit Ave Everett WA 98201-3309 |
| Mailing Address |
5620 183rd St Sw Apt 107 Lynnwood WA 98037-7319 |
| Practice Telephone | 4252582407 |
| Mailing Telephone | 2066786434 |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2016-12-30 |
| Authorized Official Name | MISS ANGELA LYNN PEARSON (CHEMICAL DEPENDENCY PROFESSIONAL) |
| Authorized Official Telephone | 4253220821 |
| Authorized Official Credential | CDP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
CP60344301 | WA | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EVERGREEN RECOVERY CENTERS | 11627 Airport Rd Ste B, Everett, WA 98204-8714 |
| Street Address |
2601 SUMMIT AVE |
| City | EVERETT |
| State | WA |
| Zip Code | 98201-3309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205965159 | Evergreen Manor Detox | Substance Abuse Rehabilitation Facility | 2601 Summit Ave, Everett, WA 98201 | 2007-03-05 |
| 1023625266 | Jessica Marie Allen | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2020-09-30 |
| 1215542501 | Maya Elizabeth Caldwell Eleazer | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2020-09-13 |
| 1124645866 | Jill Marie Overton | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2020-06-29 |
| 1639798192 | Shante Monique Miller | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2020-04-14 |
| 1922638352 | Michelle Agnes Mcclory | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2020-01-24 |
| 1053941658 | Sunshine Jay Graham | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2020-01-22 |
| 1649828849 | Alexandra Rose Schmidt | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2019-08-30 |
| 1659932242 | Marie Emmanuelle Brown | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2019-06-24 |
| 1700440294 | Leslie Orr | Counselor | 2601 Summit Ave, Everett, WA 98201-3309 | 2019-04-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306471867 | Shannon Michelle Dewald | Registered Nurse | D8s 1700 13th St, Everett, WA 98201 | 2020-03-05 |
| 1578123113 | Precious Medicial Spa, LLC | Registered Nurse | 1728 W. Marine View Dr Suite 212, Everett, WA 98201 | 2019-06-17 |
| 1508429796 | Alix Deschain | Counselor | 2801 Broadway, Everett, WA 98201 | 2019-04-15 |
| 1811457534 | Khushboo Patel | Pharmacist | 1330 Rockefeller Ave Ste 150, Everett, WA 98201 | 2019-03-20 |
| 1164991188 | Grace Talbot Davis | Registered Nurse | 2601 Summit Avenue, Bldg. C, Everett, WA 98201 | 2018-11-20 |
| 1063924603 | Tracy Sisk | Counselor | 3120 Colby Ave, 502, Everett, WA 98201 | 2017-11-03 |
| 1710403126 | Michelle Durham | Counselor | 3322 Boadway Fl 2, Everett, WA 98201 | 2017-08-17 |
| 1861927949 | Melanie Schmidt | Counselor | 2610 Westmore Ave, Everett, WA 98201 | 2017-04-26 |
| 1518413327 | Joseph Madson Dmd Pllc | Clinic/Center | 3802 Colby Ave, 4th Floor, Everett, WA 98201 | 2016-08-31 |
| 1043683162 | Jennifer Adams | Counselor | 1511 26th St, Everett, WA 98201 | 2015-11-11 |
| Find all providers in zip 98201 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679765226 | Kitsap County Juvenile Department | Substance Abuse Rehabilitation Facility | 1338 Sw Old Clifton Rd, Port Orchard, WA 98367-9113 | 2007-08-16 |
| 1427266386 | Ryther Child Center | Substance Abuse Rehabilitation Facility | 11729 36th Ave Ne, Seattle, WA 98125 | 2007-05-21 |
| 1548478001 | Ryther Child Center | Substance Abuse Rehabilitation Facility | 2400 Ne 95th St, Seattle, WA 98115-2426 | 2007-05-18 |
| 1134292501 | Lakeside Recovery Centers Inc | Substance Abuse Rehabilitation Facility | 12845 Ambaum Blvd Sw, Seattle, WA 98146 | 2006-11-15 |
| 1962921411 | Crystal Jane Andrews | Substance Abuse Rehabilitation Facility | 628 S Cowley St, Spokane, WA 99202-1377 | 2017-09-15 |
| 1184158750 | The Healing Lodge of The Seven Nations | Substance Abuse Rehabilitation Facility | 5600 E 8th Ave, Spokane Valley, WA 99212-0220 | 2017-04-20 |
| 1992183685 | Felicia Cassandra Reineman | Substance Abuse Rehabilitation Facility | 3754 W Indian Trail Rd, Spokane, WA 99208-4736 | 2015-05-13 |
| 1194118539 | New Developed Nations, LLC | Substance Abuse Rehabilitation Facility | 631 S Richard Allen Ct, Spokane, WA 99202-2345 | 2015-03-10 |
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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.