Evergreen Place LLC
NPI #1215456777 in Midvale, Utah
Provider Information
- NPI Number
- 1215456777
- Entity Type
- Organization
- Organization Name
- Evergreen Place LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Sep 15, 2017
- Last Updated
- Mar 17, 2018
Practice Location
Authorized Official
- Name
- JORGE GUSTAVO GONZALEZ VILLARRUEL
- Title
- OWNER
- Phone
- (801) 921-0070
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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