Organization
EVERGREEN HOMECARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JISOOK KIM (PROSSESSOR)
(917) 968-2655
Entity
Organization
Contact information
Practice address
513 WATERVIEW DR, COPPELL, TX 75019-6617
(917) 968-2655
Mailing address
513 WATERVIEW DR, COPPELL, TX 75019-6617
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/14/2019
Last updated
09/14/2019
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