Evergreen Assisted Living LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

EVERGREEN ASSISTED LIVING LLC

Practice address

6521 Clearhaven Cir
Dallas, TX 75248-4017

Phone

(972) 735-9604

Fax

(972) 735-9602

NPI assigned

May 3, 2011

Organization subpart

No

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

Authorized official

Name

Vinil Patel

Title

Owner/Administrator

Phone

(972) 735-9604

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304380800000",
    "number": "1033401500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6521 CLEARHAVEN CIR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752484017",
            "telephone_number": "972-735-9604",
            "fax_number": "972-735-9602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6521 CLEARHAVEN CIR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752484017",
            "telephone_number": "972-735-9604",
            "fax_number": "972-735-9602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-03",
        "last_updated": "2011-05-03",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "VINIL",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "972-735-9604"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Brandon Paul Everett
• Elizabeth Marie Everett, P.A.-C
• Rachel Everett, MCN, RDN, LD
• Evergreen DME LLC
• Evergreen Presbyterian Ministries of Texas, Inc.
• Evergreen Presbyterian Ministries of Texas, Inc.
• Evergreen Presbyterian Ministries of Texas, Inc.
• Nicole Everitt, MA, LPC

• In Home Supportive Care Agency in Dallas, TX
• Providers in Dallas, TX by specialty
• In Home Supportive Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; 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.