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1487335709 NPI number — EVERGREEN LIFE CARE HOMES INC.

NPI Number: 1487335709
Health Care Provider/Practitioner: EVERGREEN LIFE CARE HOMES INC.

Information about “1487335709” NPI (EVERGREEN LIFE CARE HOMES INC.) exists in 1487335709 in HTML format HTML  |  1487335709 in plain Text format TXT  |  1487335709 in PDF (Portable Document Format) PDF  |  1487335709 in an XML format XML  formats.

NPI Number : 1487335709 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1487335709",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "EVERGREEN LIFE CARE HOMES INC.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3092 HANSON AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CLOVIS",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "93611-3917",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "408-483-0196",
    "MailingAddressFaxNumber": "559-468-0030",
    "FirstLinePracticeLocationAddress": "542 W BROWNING AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FRESNO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "93704-1802",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "498-483-0196",
    "PracticeLocationAddressFaxNumber": "449-468-0030",
    "EnumerationDate": "07/28/2023",
    "LastUpdateDate": "07/28/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ROYCHOUDHURY",
    "AuthorizedOfficialFirstName": "MINAKSHI",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "LICENSEE/ADMINISTRATOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "408-483-0196",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "310400000X",
        "TaxonomyName": "Assisted Living Facility",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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