Evergreen Living #4
NPI #1255452017 in Leicester, North Carolina
Provider Information
- NPI Number
- 1255452017
- Entity Type
- Organization
- Organization Name
- Evergreen Living #4
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Apr 2, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 351 FAMILY RIDGE ROAD
- City
- Leicester
- State
- North Carolina
- ZIP Code
- 28748
- Phone
- (828) 779-5588
Authorized Official
- Name
- YOUNG S LEE
- Title
- OWNER
- Phone
- (828) 779-5588
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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