Evergreen Community Homes INC

NPI #1205589173 in Rosedale, Maryland

Provider Information

NPI Number: 1205589173
Entity Type: Organization
Organization Name: Evergreen Community Homes INC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 1, 2022
Last Updated: Feb 1, 2022

Practice Location

Address: 13 BROADBRIDGE RD
City: Rosedale
State: Maryland
ZIP Code: 21237-1558
Phone: (443) 642-9933

Authorized Official

Name: MRS. NGOZI GLORIA WILKENS, NURSE
Title: ADMINISTRATOR
Phone: (443) 642-9933

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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