# EVERGREEN HOME HEALTH, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104821537
- **Authorized official:** MRS. LYDIA Y AHN RN, PHN (ADMINISTRATOR/CEO)
- **Authorized official phone:** (562) 860-9444

## Contact information

- **Practice address:** 17215 STUDEBAKER RD, STE 270, CERRITOS, CA 90703-2522
- **Practice address phone:** (562) 860-9444
- **Practice address fax:** (562) 860-8334
- **Mailing address:** 17215 STUDEBAKER RD, STE 270, CERRITOS, CA 90703-2522
- **Mailing address phone:** (562) 860-9444
- **Mailing address fax:** (562) 860-8334

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | CA | Yes |

## Other

- **Enumeration date:** 06/13/2005
- **Last updated:** 10/08/2007