Organization
EVERGREEN HEALTHCARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE RENE WHITE LVN (ADON/ MEDICARE MANAGER)
(940) 704-6682
Entity
Organization
Contact information
Practice address
406 E 7TH ST, BURKBURNETT, TX 76354-2017
(940) 569-2236
(940) 569-1299
Mailing address
406 E 7TH ST, BURKBURNETT, TX 76354-2017
(940) 569-2236
(940) 569-1299
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004413
—
TX
Enumeration date
10/10/2005
Last updated
08/22/2020
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