Organization
EVERGREEN LIVING HOME #4
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA LEA (ADMINISTRATOR)
(828) 279-9592
Entity
Organization
Contact information
Practice address
230 COUNTRY TIME CIRCLE, LEICESTER, NC 28748
(828) 683-8884
Mailing address
PO BOX 1808, LEICESTER, NC 28748-1808
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL-011-248
NC
Other
Enumeration date
06/27/2007
Last updated
08/22/2020
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