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Organization

EVERGREEN COURT HOME FOR ADULTS SP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH SCHONBERGER (MEMBER)
(732) 363-7770
Entity
Organization

Contact information

Practice address
65 LAFAYETTE ST, SPRING VALLEY, NY 10977-5184
(845) 356-7700
Mailing address
29 WHISPERING PINES LN, LAKEWOOD, NJ 08701-1421

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
620-F-078
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04338354
NY
Enumeration date
09/29/2016
Last updated
09/29/2016
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