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Organization
EVERGREEN RETIREMENT COMMUNITY, INC.
Active
Organization
EVERGREEN RETIREMENT COMMUNITY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PEGGY F BELLIN RN (HEALTH CENTER ADMINISTRATOR)
(920) 237-6200
Entity
Organization
Contact information
Practice address
1130 N WESTFIELD ST, OSHKOSH, WI 54902-3217
(920) 233-2340
(920) 237-2109
Mailing address
1130 N WESTFIELD ST, OSHKOSH, WI 54902-3217
(920) 233-2340
(920) 237-2109
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20136400
—
WI
Enumeration date
08/24/2005
Last updated
07/29/2022
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