Evergreen Court Home for Adults SP LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

620-F-078 Issued in NY

Legal business name

EVERGREEN COURT HOME FOR ADULTS SP LLC

Practice address

65 Lafayette St
Spring Valley, NY 10977-5184

Phone

(845) 356-7700

NPI assigned

Sep 29, 2016

Last updated

Sep 29, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph Schonberger

Title

Member

Phone

(732) 363-7770

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1475107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475107200000",
    "number": "1295284453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 WHISPERING PINES LN",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 LAFAYETTE ST",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775184",
            "telephone_number": "845-356-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN COURT HOME FOR ADULTS SP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-29",
        "last_updated": "2016-09-29",
        "status": "A",
        "authorized_official_last_name": "SCHONBERGER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "732-363-7770"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NY",
            "license": "620-F-078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04338354",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isela Maria Escobar, FNP
• Juan Bautista Espaillat, D.D.S.
• Brianne Esteves
• Vanessa Etienne, LPN
• Wideline Etienne
• Nelie Exalus
• Mirnette Exantus, REGISTERED NURSE
• Viktoria Eydelman-Grinn
• Boruch Ezagui
• F H L Dental Care P C

• Assisted Living Facility in Spring Valley, NY
• Providers in Spring Valley, NY by specialty
• Assisted Living Facility in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2016; 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.