| NPI | 1194358119 |
|---|---|
| Doing Business As | EVERGREEN VILLAGE AT FORT WAYNE |
| Entity Type | Organization |
| Authorized Contact | GREG ECHOLS Co President Of Management Company 815-935-1992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2023-10-11 |