Organization
EVERGREEN COMMUNITY HOMES INC
Active
Other names
EVERGREEN COMMUNITY HOMES INC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NGOZI GLORIA WILKENS NURSE (ADMINISTRATOR)
(443) 642-9933
Entity
Organization
Contact information
Practice address
13 BROADBRIDGE RD, ROSEDALE, MD 21237-1558
(443) 642-9933
Mailing address
13 BROADBRIDGE RD, ROSEDALE, MD 21237-1558
(443) 642-9933
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/01/2022
Last updated
02/01/2022
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