NPI | 1720109580 |
---|---|
Doing Business As | EVERGREEN LIVING HOME #13 |
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-011-198) |
Enumeration Date | 2007-04-02 |
Last Update Date | 2023-09-08 |