NPIMap

Organization Active NPI

Evergreen Assisted Living Homes Inc- Red Robin

  • Assisted Living Facility
  • Richfield, MN
National Provider Identifier
1093577967
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
EVERGREEN ASSISTED LIVING HOMES INC- RED ROBIN
Practice address
6629 Xexes Ave S
Richfield, MN 55423
Phone
(651) 280-0210
Fax
(612) 500-4948
NPI assigned
Jan 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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

Authorized official

Name
Eunie Buford, RN
Title
Presidents
Phone
(651) 280-0210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

6629 Xexes Ave S
Richfield, MN 55423

Mailing address

7016 Antrim Rd
Edina, MN 55439-1708

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Assisted Living Homes Inc- Red Robin6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706227200000",
    "number": "1093577967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7016 ANTRIM RD",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554391708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6629 XEXES AVE S",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "55423",
            "telephone_number": "651-280-0210",
            "fax_number": "612-500-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN ASSISTED LIVING HOMES INC- RED ROBIN",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-23",
        "status": "A",
        "authorized_official_last_name": "BUFORD",
        "authorized_official_first_name": "EUNIE",
        "authorized_official_title_or_position": "PRESIDENTS",
        "authorized_official_telephone_number": "651-280-0210",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richfield, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; 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.