# EVERGREEN ASSISTED LIVING HOMES INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EVERGREEN ASSISTED LIVING HOME
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1184591620
- **Legal business name:** EVERGREEN ASSISTED LIVING HOME
- **Authorized official:** EUNWON BUFORD CBO (CBO)
- **Authorized official phone:** (651) 280-0210

## Contact information

- **Practice address:** 7016 ANTRIM RD, EDINA, MN 55439-1708
- **Practice address phone:** (612) 234-2101
- **Mailing address:** 2526 THOMAS AVE S, MINNEAPOLIS, MN 55405-2344
- **Mailing address phone:** (612) 234-2101
- **Mailing address fax:** (612) 500-4948

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/20/2025
- **Last updated:** 10/20/2025