<Unavail>

LBN: Evergreen Care Center Llc
<Unavail> is an health care organization with primary practice located at 1250 S Evergreen St , Shawano WI 54166-3514. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty. Evergreen Care Center Llc can be contacted via phone (715) 526-3107, or through Parkins, Robert M via phone (920) 364-9754.

Contact Information

Primary practice address
1250 S Evergreen St Shawano WI 54166-3514
Phone: (715) 526-3107
Fax: (715) 524-8037
Website:
Map and Directions
Authorized official contact:
Name: Parkins, Robert M
Phone: (920) 364-9754

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 2896 Wisconsin

Profile Details

NPI number 1316939861
LBN Legal business name Evergreen Care Center Llc
DBA Doing business as <Unavail>
Authorized official Parkins, Robert M
Entity Organization
Organization subpart 1 No
Enumeration date Aug 19th, 2005
Last updated May 27th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316939861 NPPES
Wisconsin MEDICAID 20192000

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