Evergreen Health Care Center
LBN: Johnson Evergreen Corporation
Evergreen Health Care Center is an health care organization with primary practice located at 205 Chestnut Hill Rd , Stafford Springs CT 06076-4005. 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.
Johnson Evergreen Corporation can be contacted via phone (860) 684-8714, or through Romanowski, Anna via phone (860) 684-8714.
Contact Information
Primary practice address
205 Chestnut Hill Rd
Stafford Springs CT 06076-4005
Phone: (860) 684-8714
Fax: (860) 684-8723
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | 2081-C | Connecticut |
Profile Details
| NPI number | 1053427609 |
|---|---|
| LBN Legal business name | Johnson Evergreen Corporation |
| DBA Doing business as | Evergreen Health Care Center |
| Authorized official | Romanowski, Anna |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 23rd, 2006 |
| Last updated | May 14th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053427609 | NPPES |
| Connecticut | Other | 712385 | CONNECTICARE PROVIDER NUM |
| Connecticut | Other | 44044 | CONNECTICARE PROVIDER NUM |
| Connecticut | Other | A3796830 | CONNECTICARE PROVIDER NUM |
| Connecticut | MEDICAID | 000020529 | CONNECTICARE PROVIDER NUM |
| Connecticut | Other | 833 | CONNECTICARE PROVIDER NUM |
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