NPIMap

Organization Active NPI

Evergreen Assisted Living Homes Inc

  • In Home Supportive Care Agency
  • Edina, MN
National Provider Identifier
1184591620
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
EVERGREEN ASSISTED LIVING HOMES INC
Practice address
7016 Antrim Rd
Edina, MN 55439-1708
Phone
(612) 234-2101
NPI assigned
Oct 20, 2025
Organization subpart
Yes
Parent organization
EVERGREEN ASSISTED LIVING HOMEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Authorized official

Name
Eunwon Buford, CBO
Title
Cbo
Phone
(651) 280-0210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

7016 Antrim Rd
Edina, MN 55439-1708

Mailing address

2526 Thomas Ave S
Minneapolis, MN 55405-2344
Phone (612) 234-2101

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Assisted Living Homes Inc6 organizations share this tax ID, including this one
Part of
Evergreen Assisted Living Homes Inc

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": "1760918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760918400000",
    "number": "1184591620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2526 THOMAS AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052344",
            "telephone_number": "612-234-2101",
            "fax_number": "612-500-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7016 ANTRIM RD",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554391708",
            "telephone_number": "612-234-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN ASSISTED LIVING HOMES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERGREEN ASSISTED LIVING HOME",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A",
        "authorized_official_last_name": "BUFORD",
        "authorized_official_first_name": "EUNWON",
        "authorized_official_title_or_position": "CBO",
        "authorized_official_telephone_number": "651-280-0210",
        "authorized_official_credential": "CBO"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.