NPI | 1205956398 |
---|---|
Doing Business As | EVERGREEN LIVING HOME #2 |
Entity Type | Organization |
Authorized Contact | YOUNG SONG LEE Owner 828-779-5588 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-011-194) |
Enumeration Date | 2007-03-30 |
Last Update Date | 2023-09-08 |