Organization
EVERGREEN HOME HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD KELTERBORN (ADMINISTRATOR)
(248) 620-1211
Entity
Organization
Contact information
Practice address
5980 S MAIN ST, SUITE 102, CLARKSTON, MI 48346
(248) 620-1211
(248) 620-1214
Mailing address
5980 S MAIN ST, SUITE 102, CLARKSTON, MI 48346
(248) 620-1211
(248) 620-1214
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
MI638061
MI
Other
Enumeration date
05/31/2005
Last updated
08/22/2020
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