Organization
EVERGREEN CHATEAU INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRAIG MATTHEW MICHAYLUK DBA (PRESIDENT)
(818) 359-9447
Entity
Organization
Contact information
Practice address
13530 SHERMAN WAY, VAN NUYS, CA 91405-2830
(818) 902-9501
Mailing address
PO BOX 7610, NORTHRIDGE, CA 91327-7610
(818) 902-9501
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
197607308
CA
Other
Enumeration date
12/31/2008
Last updated
12/31/2008
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