| 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 |