Organization
EVERGREEN SENIOR LIVING,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACOB FAHIMIPOUR (ADMINISTRATOR)
(818) 331-2320
Entity
Organization
Contact information
Practice address
23635 COLLINS ST, WOODLAND HILLS, CA 91367-5916
(818) 331-2320
(818) 704-7339
Mailing address
23635 COLLINS ST, WOODLAND HILLS, CA 91367-5916
(818) 331-2320
(818) 704-7339
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
197608576
CA
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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