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Organization

EVERGREEN PLACE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BETH ANN MCGARRY LNHA (ADMINISTRATOR)
(218) 652-6702
Entity
Organization

Contact information

Practice address
23299 285TH AVE, AKELEY, MN 56433-8020
(218) 652-6702
(218) 652-6710
Mailing address
23299 285TH AVE, AKELEY, MN 56433-8020
(218) 652-6702
(218) 652-6710

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
1075244
MN
385H00000X
Respite Care
1075464-1HCBS
MN

Other

Enumeration date
11/19/2014
Last updated
11/19/2014
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