Organization
EVERGREENE PROPERTIES OF NORTH CAROLINA,LLC
Active
Other names
CRESTPARK RETIREMENT INN OF HELENA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL C GREENE (MANAGER)
(336) 668-3896
Entity
Organization
Contact information
Practice address
110 HOSPITAL DR, HELENA, AR 72342-1507
(870) 338-3405
(870) 338-3499
Mailing address
PO BOX 310, HELENA, AR 72342-0310
(870) 338-3405
(870) 338-3499
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
639
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015349
BCBS PROVIDER NUMBER
AR
Enumeration date
08/08/2006
Last updated
08/22/2020
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