Provider Demographics
NPI:1417348350
Name:SSM EVERGREEN ENTERPRISES, INC.
Entity Type:Organization
Organization Name:SSM EVERGREEN ENTERPRISES, INC.
Other - Org Name:RIGHT AT HOME NORTHWEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-392-3934
Mailing Address - Street 1:114 W MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4368
Mailing Address - Country:US
Mailing Address - Phone:360-392-3934
Mailing Address - Fax:
Practice Address - Street 1:114 W MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4368
Practice Address - Country:US
Practice Address - Phone:360-392-3934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIHS.FS.60298689253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care