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EVERGREEN VALLEY NURSING HOME

Adult Care Home

Plattsburgh, New York

Provider NPI: 1316033152

Organization Information:
Organization Name:  EVERGREEN VALLEY NURSING HOME


Practice Location:
8 BUSHEY BLVD  PLATTSBURGH, NY 12901 US
Tel: 518-563-3261  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
Adult Care Home
NY0901301N

Other Provider Identifiers:

IssuerNumberStateType
02329757NY05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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