Evergreen Living Home #12

LBN: Evergreen Living Home Inc.
Evergreen Living Home #12 is an health care organization with primary practice located at 353 Family Ridge Road , Leicester NC 28748. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Adult Care Home, which is considered as the primary health care specialty. Evergreen Living Home Inc. can be contacted via phone (828) 779-5588, or through Lee, Young Song via phone (828) 779-5588.

Contact Information

Primary practice address
353 Family Ridge Road Leicester NC 28748
Phone: (828) 779-5588
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Lee, Young Song
Phone: (828) 779-5588

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Adult Care Home 311ZA0620X FCL-011-198 North Carolina

Profile Details

NPI number 1811018674
LBN Legal business name Evergreen Living Home Inc.
DBA Doing business as Evergreen Living Home #12
Authorized official Lee, Young Song
Entity Organization
Organization subpart 1 No
Enumeration date Apr 2nd, 2007
Last updated Sep 8th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811018674 NPPES
North Carolina MEDICAID 7805219

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