Organization
EVERGREEN HOME HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYDIA Y AHN RN, PHN (ADMINISTRATOR/CEO)
(562) 860-9444
Entity
Organization
Contact information
Practice address
17215 STUDEBAKER RD, STE 270, CERRITOS, CA 90703-2522
(562) 860-9444
(562) 860-8334
Mailing address
17215 STUDEBAKER RD, STE 270, CERRITOS, CA 90703-2522
(562) 860-9444
(562) 860-8334
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HHA08132F
—
CA
Enumeration date
06/13/2005
Last updated
10/08/2007
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