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Organization

THE EVERGREENS, INC.

Active
Other names
Evergreens Senior Healthcare System
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARILYN GARDNER LNHA (ADMINISTRATOR)
(336) 292-8620
Entity
Organization

Contact information

Practice address
4007 W WENDOVER AVE, GREENSBORO, NC 27407-1904
(336) 292-8620
(336) 854-7122
Mailing address
4007 W WENDOVER AVE, GREENSBORO, NC 27407-1904
(336) 292-8620
(336) 854-7122

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
NH0073
NC
314000000X
Skilled Nursing Facility
Primary
NH0073
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00829
BCBS OF NC PROVIDER NO
NC
05
3405016
NC
05
3406162
NC
01
40251
PARTNERS INS PROVIDER NO
NC
Enumeration date
07/26/2006
Last updated
11/15/2007
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