Organization
EVERGREEN MANOR, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLEN G CYR (VP OF FINANCE)
(207) 786-3554
Entity
Organization
Contact information
Practice address
328 NORTH ST, SACO, ME 04072-1814
(207) 282-5161
(207) 282-5163
Mailing address
179 LISBON ST, 2ND FLOOR, LEWISTON, ME 04240-7248
(207) 786-3554
(207) 786-8507
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
36405
ME
Other
Enumeration date
12/11/2006
Last updated
04/20/2008
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