# EVERGREEN RETIREMENT COMMUNITY, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EVERGREEN RETIREMENT COMMUNITY, INC.
- **Other names:** Evergreen At Home
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588097810
- **Legal business name:** EVERGREEN RETIREMENT COMMUNITY, INC.
- **Authorized official:** MRS. PEGGY BELLIN RN (ADMINISTRATOR)
- **Authorized official phone:** (920) 237-2140

## Contact information

- **Practice address:** 1125 N WESTFIELD ST, OSHKOSH, WI 54902-3216
- **Practice address phone:** (920) 237-6205
- **Practice address fax:** (920) 966-0334
- **Mailing address:** 1125 N WESTFIELD ST, OSHKOSH, WI 54902-3216
- **Mailing address phone:** (844) 654-7600
- **Mailing address fax:** (920) 966-0334

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1186 | WI | Yes |

## Other

- **Enumeration date:** 08/09/2013
- **Last updated:** 07/29/2022