Organization
THE EVERGREENS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES A NEWMAN JR. LNHA (ADMINISTRATOR)
(336) 886-4121
Entity
Organization
Contact information
Practice address
206 GREENSBORO RD, HIGH POINT, NC 27260-3456
(336) 886-4121
(336) 886-6285
Mailing address
206 GREENSBORO RD, HIGH POINT, NC 27260-3456
(336) 886-4121
(336) 886-6285
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
NH0236
NC
314000000X
Skilled Nursing Facility
Primary
NH0236
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00830
BCBS PROVIDER NUMBER
NC
01
—
23497
PARTNERS PROVIDER NUMBER
NC
05
—
3405178
—
NC
05
—
3406161
—
NC
01
—
7801625
MCAID PCS PROVIDER NO
NC
Enumeration date
07/28/2006
Last updated
11/15/2007
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