Organization
SL EVERGREEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI J WARD LNHA (EXECUTIVE DIRECTOR)
(513) 948-2308
Entity
Organization
Contact information
Practice address
230 W GALBRAITH RD, CINCINNATI, OH 45215-5223
(513) 948-2308
(513) 948-0063
Mailing address
230 W GALBRAITH RD, CINCINNATI, OH 45215-5223
(513) 948-2308
(513) 948-0063
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
2852
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2852
CITY LICENSURE
OH
Enumeration date
07/29/2005
Last updated
08/22/2020
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