Organization
EVERGREEN LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY ROBERT HIGGINBOTHAM (OWNER)
(417) 850-3063
Entity
Organization
Contact information
Practice address
445 E 10TH ST, BAXTER SPRINGS, KS 66713-1614
(620) 856-2756
Mailing address
PO BOX 92, RACINE, MO 64858-0092
(417) 850-3063
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
03/11/2025
Last updated
03/11/2025
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