NPI | 1063974418 |
---|---|
Doing Business As | EVERGREEN PLACE |
Entity Type | Organization |
Authorized Contact | DAVID M UNDERWOOD Exec VP Finance & CFO 309-823-7135 |
Organization Subpart ? | Yes |
Primary Taxonomy | 310400000X Assisted Living Facility |
Enumeration Date | 2019-04-04 |
Last Update Date | 2019-04-04 |