Evergreen Adult Home Care Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EVERGREEN ADULT HOME CARE INC.

Practice address

362 N Swidler St
Orange, CA 92869-2827

Phone

(951) 893-0859

NPI assigned

Nov 16, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tamanna Rahman

Title

Ceo

Phone

(951) 893-0859

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1013626274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 LEXINGTON DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928783682",
            "telephone_number": "951-893-0859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 N SWIDLER ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928692827",
            "telephone_number": "951-893-0859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN ADULT HOME CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "RAHMAN",
        "authorized_official_first_name": "TAMANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-893-0859"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Orange, CA
• Providers in Orange, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.