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EVERGREEN LIVING #13

Adult Care Home

Leicester, North Carolina

Provider NPI: 1720109580

Organization Information:
Organization Name:  EVERGREEN LIVING #13


Practice Location:
353 FAMILY RIDGE ROAD  LEICESTER, NC 28748 US
Tel: 828-779-5588  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
Adult Care Home
NCFCL-011-198

Other Provider Identifiers:

IssuerNumberStateType
7805219NC05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




ADULT CARE JOBS NC - Page 1



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