EVERGREEN DICKINSON LLC NPI 1316143175

NPI Information

  • NPI: 1316143175
  • Provider Name: EVERGREEN DICKINSON, LLC
  • Classification: Custodial Care Facility - 311Z00000X
  • Entity Type: Organization
  • Address: 2143 6TH AVE W
    DICKINSON, ND
    ZIP 58601
  • Phone: (701) 483-6606

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NPI Details

EVERGREEN DICKINSON, LLC is a custodial care facility in Dickinson, ND. The provider is a facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. EVERGREEN DICKINSON, LLC NPI is 1316143175. The provider is registered as an organization entity type.

The provider's business location address is:

2143 6TH AVE W
DICKINSON, ND
ZIP 58601-700
Phone: (701) 483-6606

The provider's authorized official is Vickie Cofer .
The authorized official title is Asst. Director and has the following contact phone number (701) 483-6606.

The enumeration date for this NPI number is 6/26/2007 and was last updated on 11/18/2008.

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
1311Z00000XCustodial Care Facility8054ANORTH DAKOTAYes

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
1030765MEDICAIDNORTH DAKOTA

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: 11/21/2025

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