# EVERGREEN HEALTH CARE & GROUP HOME LLC

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

## Provider details

- **NPI number:** 1467254235
- **Authorized official:** DELVINE NKONGHO AYUK DELVINE AYUK (OWNER)
- **Authorized official phone:** (943) 238-3539

## Contact information

- **Practice address:** 7147 MOUNT ZION CIR APT 1203, MORROW, GA 30260-3330
- **Practice address phone:** (943) 238-3539
- **Mailing address:** 7147 MOUNT ZION CIR APT 1203, MORROW, GA 30260-3330
- **Mailing address phone:** (470) 894-0009

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | — | — |
| 251J00000X | Nursing Care Agency | — | — | — |
| 251S00000X | Community/Behavioral Health Agency | — | — | — |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | — | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | — | — |
| 310400000X | Assisted Living Facility | — | — | — |
| 314000000X | Skilled Nursing Facility | — | — | — |

## Other

- **Enumeration date:** 03/25/2025
- **Last updated:** 08/28/2025