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 |