NPIMap

Organization Active NPI

Evergreen Assisted Living Homes Inc

  • Assisted Living Facility
  • Chanhassen, MN
National Provider Identifier
1316713670
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
EVERGREEN ASSISTED LIVING HOMES INC
Practice address
1215 Lake Lucy Rd
Chanhassen, MN 55317-9433
Phone
(651) 280-0210
NPI assigned
Nov 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Authorized official

Name
Eunie Buford
Title
Administrator
Phone
(651) 280-0210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1215 Lake Lucy Rd
Chanhassen, MN 55317-9433

Mailing address

7016 Antrim Rd
Edina, MN 55439-1708

Other practice location 1

6629 Xexes Ave S
Richfield, MN 55423
Phone (612) 861-8080

Other practice location 2

5517 Highland Rd
Minnetonka, MN 55345-5634
Phone (651) 280-0210

Other practice location 3

6616 Sheridan Ave S
Richfield, MN 55423-2050
Phone (651) 280-0210

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": "1701129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1316713670",
    "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": "1215 LAKE LUCY RD",
            "city": "CHANHASSEN",
            "state": "MN",
            "postal_code": "553179433",
            "telephone_number": "651-280-0210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6629 Xexes Ave S",
            "address_purpose": "LOCATION",
            "city": "Richfield",
            "state": "MN",
            "postal_code": "55423",
            "country_code": "US",
            "telephone_number": "612-861-8080",
            "fax_number": "612-439-4116",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5517 Highland Rd",
            "address_purpose": "LOCATION",
            "city": "Minnetonka",
            "state": "MN",
            "postal_code": "553455634",
            "country_code": "US",
            "telephone_number": "651-280-0210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6616 Sheridan Ave S",
            "address_purpose": "LOCATION",
            "city": "Richfield",
            "state": "MN",
            "postal_code": "554232050",
            "country_code": "US",
            "telephone_number": "651-280-0210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVERGREEN ASSISTED LIVING HOMES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-28",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "BUFORD",
        "authorized_official_first_name": "EUNIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "651-280-0210"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chanhassen, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.