Evergreen Care Community LLC
NPI #1922969294 in New Brighton, Minnesota
Provider Information
- NPI Number
- 1922969294
- Entity Type
- Organization
- Organization Name
- Evergreen Care Community LLC
- Primary Specialty
- In Home Supportive Care
- Enumeration Date
- Nov 18, 2025
- Last Updated
- Nov 18, 2025
Practice Location
- Address
- 710 5TH ST SW APT 304
- City
- New Brighton
- State
- Minnesota
- ZIP Code
- 55112-7777
- Phone
- (612) 222-0828
Authorized Official
- Name
- SIDDISTO MOHAMED MUMED
- Title
- OWNER
- Phone
- (612) 222-0828
Specialties & Taxonomy Codes
| Specialty |
|---|
| In Home Supportive Care |
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