Organization
EVERGREEN ASSISTED LIVING COMMUNITY LLC
Active
Other names
Evergreen Group Home Services
Organization subpart
No
Provider details
NPI number
Authorized official
PATIENCE OGWA ODUPELU (OWNER/ PROGRAM DIRECTOR)
(540) 613-0757
Entity
Organization
Contact information
Practice address
4222 MOOMAW AVE NW, ROANOKE, VA 24017-4314
(540) 613-0757
(540) 491-9319
Mailing address
4222 MOOMAW AVE NW, ROANOKE, VA 24017-4314
(540) 613-0757
(540) 491-9319
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/07/2020
Last updated
05/07/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us