Organization
EVERGREEN HOME HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAO C YANG (DIRECTOR)
(651) 487-2074
Entity
Organization
Contact information
Practice address
1088 RICE ST, SUITE 6, SAINT PAUL, MN 55117-2906
(651) 487-5094
Mailing address
1088 RICE ST, SUITE 6, SAINT PAUL, MN 55117-2906
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
332195
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110308
HEALTH PARTNER
MN
01
—
4980376
MEDICA MSHO
MN
Enumeration date
11/16/2006
Last updated
08/22/2020
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