Organization
EVERGREEN HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED DAHIR (CEO)
(619) 882-0072
Entity
Organization
Contact information
Practice address
2529 W DARREL RD, PHOENIX, AZ 85041-6457
(619) 882-0072
Mailing address
2529 W DARREL RD, PHOENIX, AZ 85041-6457
(619) 882-0072
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/11/2021
Last updated
02/11/2021
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