Organization
EVERGREEN MANOR RETIREMENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YEE-CHUN TAN KAPUSINSKY RD (ADMINISTRATOR)
(727) 480-2180
Entity
Organization
Contact information
Practice address
3297 STATE ROAD 580, SAFETY HARBOR, FL 34695-4929
(727) 724-3776
Mailing address
3297 STATE ROAD 580, SAFETY HARBOR, FL 34695-4929
(727) 724-3776
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
AL8760
FL
Other
Enumeration date
11/21/2008
Last updated
11/21/2008
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