Organization
EVERGREEN RESIDENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMEI WOO (ADMINISTRATOR)
(775) 787-9520
Entity
Organization
Contact information
Practice address
1305 KINGS CT, RENO, NV 89503-3521
(775) 787-9520
(775) 747-7417
Mailing address
1305 KINGS CT, RENO, NV 89503-3521
(775) 787-9520
(775) 747-7417
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
3275AGC-6
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005716003
—
NV
Enumeration date
01/02/2007
Last updated
07/22/2008
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