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Organization
EVERGREENS ASSISTED LIVING
Active
Organization
EVERGREENS ASSISTED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAN GRENWAY (MANAGER)
(301) 604-1761
Entity
Organization
Contact information
Practice address
8795 MISSION RD, JESSUP, MD 20794-3943
(301) 604-1761
(301) 490-6256
Mailing address
8795 MISSION RD, JESSUP, MD 20794-3943
(301) 604-1761
(301) 490-6256
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
13AL160
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
783697000
—
MD
Enumeration date
09/20/2007
Last updated
09/20/2007
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