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Organization

EVERGREEN QUALITY HOME

Active
Other names
Adult Family Home
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARCIA ROIAL-CRACIUN (PROVIDER)
(360) 885-7933
Entity
Organization

Contact information

Practice address
304 NW 102ND ST, VANCOUVER, WA 98685-5233
(360) 885-7933
(360) 573-7131
Mailing address
304 NW 102ND ST, VANCOUVER, WA 98685-5233
(360) 885-7933
(360) 573-7131

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
654400
WA

Other

Enumeration date
05/17/2011
Last updated
05/17/2011
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