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Evergreen Supported Living, LLC

NPI #1235580820 in Whitehall, Ohio

Provider Information

NPI Number
1235580820
Entity Type
Organization
Organization Name
Evergreen Supported Living, LLC
Primary Specialty
In Home Supportive Care
Enumeration Date
Jun 25, 2016
Last Updated
Jun 25, 2016

Practice Location

Address
5150 E MAIN ST STE 102
City
Whitehall
State
Ohio
ZIP Code
43213-2441
Phone
(614) 205-9982

Authorized Official

Name
DR. ANTA MOORE, DBA, MSN, CNP
Title
CEO
Phone
(614) 205-9982

Specialties & Taxonomy Codes

Specialty
In Home Supportive Care

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