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EVERGREEN VALLEY NURSING HOME NPI 1316033152


NPI Information

NPI: 1316033152
Provider Name: EVERGREEN VALLEY NURSING HOME

Doing Business As: HASSETT ADULT DAY SERVICES

Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
8 BUSHEY BLVD
PLATTSBURGH, NY
ZIP 12901
Phone: (518) 563-3261
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EVERGREEN VALLEY NURSING HOME is an adult care home custodial care facility in Plattsburgh, NY. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. EVERGREEN VALLEY NURSING HOME NPI is 1316033152. The provider is registered as an organization entity type.
The provider Is Doing Business As Hassett Adult Day Services.

The provider's business location address is:

8 BUSHEY BLVD
PLATTSBURGH, NY
ZIP 12901-761
Phone: (518) 563-3261
Fax: (518) 562-1367

The provider's authorized official is Michele Byno .
The authorized official title is Administrator and has the following contact phone number (518) 563-3261.

The enumeration date for this NPI number is 10/5/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1311ZA0620XCustodial Care FacilityAdult Care Home0901301NNEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
102329757MEDICAIDNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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