| NPI | 1750120572 |
|---|---|
| Doing Business As | EVERGREEN MANOR |
| Entity Type | Organization |
| Authorized Contact | MICHAEL JON RUFF CFO 830-334-6617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2024-05-21 |
| Last Update Date | 2024-05-21 |