Organization
EVERGREEN HOSPICE CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LYDIA Y AHN RN, PHN (ADMINISTRATOR)
(562) 865-9006
Entity
Organization
Contact information
Practice address
17215 STUDEBAKER RD, SUITE 100, CERRITOS, CA 90703-2548
(562) 865-9006
(562) 865-9022
Mailing address
17215 STUDEBAKER RD, SUITE 100, CERRITOS, CA 90703-2548
(562) 865-9006
(562) 865-9022
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
550000319
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629270699
—
CA
Enumeration date
06/01/2007
Last updated
04/22/2011
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