| NPI | 1881104289 |
|---|---|
| Doing Business As | EVERGREEN VILLAGE AT BLOOMINGTON |
| Entity Type | Organization |
| Authorized Contact | GREG ECHOLS Co President Of Management Agent 815-935-1992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2023-10-11 |