CCN: 675379 NPI: 1912997222 Organization

EVERGREEN MANOR

111 RUTHLYNN DR
LONGVIEW, TX 756055635

Contact Information

Phone 9037572557
Fax 9037575709
Enumeration Date 2005-10-27
Last Updated 2012-07-06

Taxonomies

Code: 332B00000X License State: TX License: 117214
Code: 332BN1400X License State: TX License: 117214
Code: 313M00000X License State: TX License: 117214
Code: 385H00000X License State: TX License: 117214
Code: 314000000X (Primary) License State: TX License: 117214

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 7

cbsaActualGeographicLocation 30980

providerType 38

caseMixIndex 1.0

vbpAdjustment 0.9805965975

censusDivision 7

cbsaActualGeographicLocation 30980

providerType 38

caseMixIndex 1.0

vbpAdjustment 0.9802564842

censusDivision 7

cbsaActualGeographicLocation 30980

providerType 38

caseMixIndex 1.0

vbpAdjustment 0.9802538758

censusDivision 7

cbsaActualGeographicLocation 30980

providerType 38

caseMixIndex 1.0

vbpAdjustment 0.9802538758

censusDivision 7

cbsaActualGeographicLocation 30980

providerType 38

caseMixIndex 1.0

vbpAdjustment 0.992

censusDivision 7

cbsaActualGeographicLocation 30980

providerType 38

caseMixIndex 1.0

vbpAdjustment 1.0

censusDivision 7

cbsaActualGeographicLocation 30980

providerType 38

caseMixIndex 1.0

vbpAdjustment 1.0102474649

censusDivision 7

cbsaActualGeographicLocation 30980

providerType 38

caseMixIndex 1.0

vbpAdjustment 0.9803449243

censusDivision 7

cbsaActualGeographicLocation 30980

providerType 38

caseMixIndex 1.0

vbpAdjustment 0.9802457176

Outpatient Payment Attributes (OPSF) View Dictionary →

No OPSF records found for this provider.