EVERGREEN AT CLANCY, L.L.C. (NPI# 1841248242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841248242 |
| Entity Type | Organization |
| Organization Name | EVERGREEN AT CLANCY, L.L.C. |
| Other Organization Name | EVERGREEN CLANCY HEALTH AND REHABILITATION CENTER |
| Practice Address |
474 Highway 282 Clancy MT 59634-9519 |
| Mailing Address |
4601 Ne 77th Ave Suite 300 Vancouver WA 98662-6729 |
| Practice Telephone | 4069338311 |
| Practice Fax Number | 4069338391 |
| Mailing Telephone | 3608926628 |
| Mailing Fax Number | 2608825793 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ANDREW V MARTINI (MANAGER) |
| Authorized Official Telephone | 3608926628 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 9261 | MT | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 310012 | 05 |
| Other Name | Type Code |
|---|---|
| Evergreen Clancy Health and Rehabilitation Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EVERGREEN AT CLANCY, L.L.C. | 4601 Ne 77th Ave Ste 300, Vancouver, WA 98662 |
| Street Address |
474 HIGHWAY 282 |
| City | CLANCY |
| State | MT |
| Zip Code | 59634-9519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700495496 | Clancy Nursing and Rehab Center LLC | Skilled Nursing Facility | 474 Highway 282, Clancy, MT 59634-9519 | 2020-07-28 |
| 1689836579 | Sara Holmes | Occupational Therapy Assistant | 474 Highway 282, Clancy, MT 59634-9519 | 2008-07-01 |
| 1578725735 | Elkhorn Health and Rehabilition | Speech-Language Pathologist | 474 Highway 282, Clancy, MT 59634-9519 | 2008-06-30 |
| 1437319746 | Elkhorn Health and Rehabilitation | Occupational Therapist | 474 Highway 282, Clancy, MT 59634-9519 | 2008-06-10 |
| 1346407830 | Elkhorn Health and Rehabilitation | Physical Therapist | 474 Highway 282, Clancy, MT 59634-9519 | 2008-05-21 |
| 1063679561 | Elkhorn Health and Rehab | Occupational Therapy Assistant | 474 Highway 282, Clancy, MT 59634-9519 | 2008-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710494083 | Angie Cristin Dailey | Speech-Language Pathologist | Pmb 2142, 1 Jackson Creek Rd, Clancy, MT 59634 | 2018-01-08 |
| 1023202520 | County of Jefferson School District #1 | Local Education Agency (LEA) | 18 Clancy Creek Rd, Clancy, MT 59634 | 2007-08-29 |
| 1205048121 | Big Sky Home Care Services L.L.C. | Home Health | 1 Jackson Creek Road, Pmb 2197, Montana City, MT 59634 | 2007-05-04 |
| 1811907884 | Derek James Williams | Family Medicine | 204 Winslow Road, Clancy, MT 59634 | 2006-08-09 |
| 1619096369 | Prickly Pear Coop - Clancy | Local Education Agency (LEA) | 18 Clancy Creek Road, Clancy, MT 59634-0000 | 2007-03-27 |
| 1205970886 | Benjamin D Swoboda | Anesthesiology | 2475 Broadway St, Helena, MT 59634-4928 | 2007-02-16 |
| 1780088088 | Rhonda Guay | Specialist | 1 Valley View Dr, Suite 102, Montana City, MT 59634-9202 | 2014-10-15 |
| 1366061913 | Amelia Tavares | Dietitian, Registered | 1 Valley View Dr Ste 104, Montana City, MT 59634-9203 | 2020-04-14 |
| 1215053301 | Carol Schmid Mcevoy | Counselor | 70 Hanging Tree Gulch, Clancy, MT 59634-9511 | 2007-03-21 |
| 1205051729 | Elkhorn Health Care Inc | Skilled Nursing Facility | 474 Mt Highway 282, Clancy, MT 59634-9519 | 2007-04-17 |
| Find all providers in zip 59634 | ||||
| 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 |
|---|---|---|---|---|
| 1205051729 | Elkhorn Health Care Inc | Skilled Nursing Facility | 474 Mt Highway 282, Clancy, MT 59634-9519 | 2007-04-17 |
| 1700495496 | Clancy Nursing and Rehab Center LLC | Skilled Nursing Facility | 474 Highway 282, Clancy, MT 59634-9519 | 2020-07-28 |
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|---|---|---|---|---|
| 1770047581 | Lakeview Assisted Living LLC | Skilled Nursing Facility | 7437 Castle Rock Lake Dr, Colstrip, MT 59323-9533 | 2019-01-25 |
| 1124426283 | Genesis Rehabilitation | Skilled Nursing Facility | 1130 17 Th Ave South, Great Falls, MT 59405 | 2014-12-05 |
| 1336546811 | Empres At Lewistown, LLC | Skilled Nursing Facility | 410 Wendell Ave, Lewistown, MT 59457-2261 | 2014-11-26 |
| 1053728014 | Montana Vamc | Skilled Nursing Facility | 210 South Winchester, Miles City, MT 59301-4757 | 2014-07-22 |
| 1912189572 | Northeast Montana Health Services,inc | Skilled Nursing Facility | 1000 6th Ave N, Wolf Point, MT 59201-1828 | 2007-12-05 |
| 1508990698 | Chouteau County District Hospital | Skilled Nursing Facility | 1501 St. Charles, Fort Benton, MT 59442 | 2007-03-14 |
| 1386790160 | Cnh Acquisitions Inc. | Skilled Nursing Facility | 3131 Amherst Ave, Butte, MT 59701-4653 | 2007-01-26 |
| 1942378534 | Memorial Hospital Association | Skilled Nursing Facility | 600 West 21st St, Red Lodge, MT 59068-0590 | 2006-12-01 |
| 1538248067 | Blackfeet Tribe | Skilled Nursing Facility | South Government Square, South Government Square, Browning, MT 59417-0728 | 2006-11-03 |
| 1417051632 | Liberty County Hospital and Nursing Home, Inc | Skilled Nursing Facility | 600 West Monroe Ave & Hwy 223, Chester, MT 59522-0705 | 2006-09-08 |
| Find all providers with the same taxonomy | ||||
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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.