Organization
EVERGREENE PROPERTIES OF NORTH CAROLINA,LLC
Active
Other names
CRESTPARK INN OF HELENA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL C GREENE (MANAGER)
(336) 668-3896
Entity
Organization
Contact information
Practice address
116 NOVEMBER, HELENA, AR 72342-1502
(870) 338-9886
(870) 338-6097
Mailing address
PO BOX 310, HELENA, AR 72342-0310
(870) 338-9886
(870) 338-6097
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
633
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015221
BCBS PROVIDER NUMBER
AR
Enumeration date
08/05/2006
Last updated
08/22/2020
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