Organization
EVERGREEN HEALTHCARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH N BAILEY MED (PRESIDENT)
(330) 652-3355
Entity
Organization
Contact information
Practice address
609 VIENNA AVE, NILES, OH 44446
(330) 652-3355
(330) 652-1477
Mailing address
EVERGREEN HEALTHCARE SERVICES, INC., PO BOX 221, NILES, OH 44446
(330) 652-3355
(330) 652-1477
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
2437643
OH
251G00000X
Community Based Hospice Care Agency
0019704300003
PA
251G00000X
Community Based Hospice Care Agency
2437643
OH
343900000X
Non-emergency Medical Transport (VAN)
Primary
2437643
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019704300003
—
PA
05
—
2434376
—
OH
Enumeration date
05/09/2007
Last updated
09/09/2020
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