| NPI | 1205025020 |
|---|---|
| Doing Business As | EVERGREENE NURSING CARE CENTER |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS K MITTLEIDER President 770-619-0866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: VA NH2551) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2008-07-25 |