NPI 1992855316 · live from the CMS NPI Registry
Evergreen Manor Senior Care Centre, LLC
Skilled Nursing Facility in Springfield, MI. National Provider Identifier 1992855316, active.
NPI record
| NPI | 1992855316 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Skilled Nursing Facility 314000000X |
| Practice location | 111 Evergreen Rd, Springfield, MI 49037 |
| Practice phone | 269-969-6110 |
| Mailing address | 10503 Citation Dr Ste 100, Brighton, MI 48116 |
| Enumerated | January 10, 2007 |
| Last updated | May 5, 2022 |
| Authorized official | Todd Sangster, Cfo |
| Other names | Evergreen Senior Care And Rehab Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies | 332BN1400X | 134160 (MI) |
| Skilled Nursing Facility primary | 314000000X | 134160 (MI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.