Organization
EVERGREEN HOMECARE SERVICE OF NY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HYUNJONG KOO (PRESIDENT)
(718) 321-2113
Entity
Organization
Contact information
Practice address
154-08 NORTHERN BLVD, SUITE 2A, FLUSHING, NY 11354
(718) 321-2113
(718) 925-4105
Mailing address
154-08 NORTHERN BLVD, SUITE 2A, FLUSHING, NY 11354
(718) 321-2113
(718) 925-4105
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04345855
—
NY
Enumeration date
05/01/2019
Last updated
07/29/2022
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