| Evergreen Supported Living | |
|
305 Flora St Bellingham WA 98225-4430 | |
| (360) 671-5898 | |
| (360) 922-0648 |
| Full Name | Evergreen Supported Living |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
| Location | 305 Flora St, Bellingham, Washington |
| Authorized Official Name and Position | Zay Aidan Smith Mcshane (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3606715898 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Supported Living 305 Flora St Bellingham WA 98225-4430 Ph: (360) 671-5898 | Evergreen Supported Living 305 Flora St Bellingham WA 98225-4430 Ph: (360) 671-5898 |
| NPI Number | 1124767587 |
|---|---|
| Provider Enumeration Date | 06/02/2022 |
| Last Update Date | 06/02/2022 |
| Certification Date | 06/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124767587 | NPI | - | NPPES |
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