Evergreen Home Health Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

MI638061 Issued in MI

Legal business name

EVERGREEN HOME HEALTH CARE LLC

Practice address

5980 S Main St
Suite 102
Clarkston, MI 48346

Phone

(248) 620-1211

Fax

(248) 620-1214

NPI assigned

May 31, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Richard Kelterborn

Title

Administrator

Phone

(248) 620-1211

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174526453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5980 S MAIN ST",
            "address_2": "SUITE 102",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48346",
            "telephone_number": "248-620-1211",
            "fax_number": "248-620-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5980 S MAIN ST",
            "address_2": "SUITE 102",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "48346",
            "telephone_number": "248-620-1211",
            "fax_number": "248-620-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN HOME HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELTERBORN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-620-1211",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": "MI638061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haley Erin Estes
• Victoria Evangelista
• Amanda Evanoff
• Leeanne Evanoff
• Evergreen Health Services, Inc.
• Evergreen Personal Services, LLC
• Edwin Fahey
• Falkner Family Chiropractic & Sports Rehab LLC
• Travis Augustus Falkner, D.C.
• Allison Marie Farrelly

• Home Health Agency in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Home Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.