Organization
LIFE CARE CENTERS OF AMERICA, INC
Active
Other names
Evergreen House Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY S. CROSS (ASSISTANT SECRETARY)
(423) 473-5867
Entity
Organization
Contact information
Practice address
1 EVERGREEN DR, EAST PROVIDENCE, RI 02914-1503
(401) 438-3250
(401) 438-4813
Mailing address
3001 KEITH ST NW, CLEVELAND, TN 37312-3713
(423) 473-5751
(423) 339-8342
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
LTC00686
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
653
—
RI
Enumeration date
03/27/2006
Last updated
09/15/2021
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