| NPI | 1861512972 |
|---|---|
| Doing Business As | EVERGREEN LIVING HOME #3 |
| 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-011-195) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2023-09-08 |