MEDICARE: EVERGREEN ELDER RESIDENTIAL CARE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1346171618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERGREEN ELDER RESIDENTIAL CARE INC

Provider Business Mailing Address
First Line	:	1204 PEORIA WAY
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95747-9574
Country	:	US
Telephone Number	:	916-666-9804
Fax Number	:	916-755-4406

Provider Business Practice Location Address
First Line	:	1204 PEORIA WAY
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95747-9574
Country	:	US
Telephone Number	:	916-666-9804
Fax Number	:	916-755-4406

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	PARMINDER KAUR
Credential	:	PK
Telephone Number	:	916-666-9804

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

Similar Medicare Providers

1528661782 — HEALTH & WELLNESS 365 LLC
Practice Location Address:

2404 KINSELLA WAY
ROSEVILLE, CA
95747-9574

Practice Phone: 561-929-6244
Practice Fax: 918-398-8932

1255344883 — AXLINE'S INC.
Practice Location Address:

125 N MAIN ST
ROSEVILLE, IL
61473-9574

Practice Phone: 309-426-2954
Practice Fax: 309-426-2565

1730078932 — BRITTANY RICHARDS MA, AMFT
Practice Location Address:

214 ESTATES DR. , BRITBRIGHTRICHARDS@GMAIL.COM
ROSEVILLE, CA
95678-9574

Practice Phone: 801-725-5817
Practice Fax:

1316878820 — PRESTON DOYLE
Practice Location Address:

1430 BLUE OAKS BLVD STE 260
ROSEVILLE, CA
95747-4003

Practice Phone: 530-887-1006
Practice Fax:

1225969736 — TAYLOR BAIERLEIN
Practice Location Address:

1430 BLUE OAKS BLVD STE 260
ROSEVILLE, CA
95747-4003

Practice Phone: 530-887-1006
Practice Fax:

1316876915 — MRS. ANNE-MARIE FARR MS, PPS
Practice Location Address:

4747 PFE RD
ROSEVILLE, CA
95747-9776

Practice Phone: 916-787-8100
Practice Fax:

Directions to “EVERGREEN ELDER RESIDENTIAL CARE INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.