Healthcare Provider Details

I. General information

NPI: 1912966698
Provider Name (Legal Business Name): EVERGREENS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 GREENSBORO RD
HIGH POINT NC
27260-3456
US

IV. Provider business mailing address

206 GREENSBORO RD
HIGH POINT NC
27260-3456
US

V. Phone/Fax

Practice location:
  • Phone: 336-886-4121
  • Fax: 336-886-6285
Mailing address:
  • Phone: 336-886-4121
  • Fax: 336-886-6285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0236
License Number StateNC

VIII. Authorized Official

Name: MR. JAMES ARNOLD NEWMAN JR.
Title or Position: ADMINISTRATOR
Credential:
Phone: 336-886-4121