Evergreen Haven LLC
NPI #1104616002 in Baxter Springs, Kansas
Provider Information
- NPI Number
- 1104616002
- Entity Type
- Organization
- Organization Name
- Evergreen Haven LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- May 12, 2025
- Last Updated
- May 12, 2025
Practice Location
- Address
- 445 E 10TH ST
- City
- Baxter Springs
- State
- Kansas
- ZIP Code
- 66713-1614
- Phone
- (620) 304-2108
Authorized Official
- Name
- MR. LARRY ROBERT HIGGINBOTHAM
- Title
- OWNER
- Phone
- (417) 850-3063
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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