Active NPI
Evergreen Adult Day Care in Ny, Inc
- Adult Day Care Clinic/Center
- Flushing, NY
National Provider Identifier
1346114352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- Legal business name
- EVERGREEN ADULT DAY CARE IN NY, INC
- Practice address
- 15012 Roosevelt Ave
Flushing, NY 11354-4936 - Phone
- (917) 563-1214
- Fax
- (917) 563-1187
- NPI assigned
- Oct 2, 2025
- Organization subpart
- Yes
- Parent organization
- EVERGREEN ADULT DAY CARE IN NY, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- So Mi Shin
- Title
- Program Director
- Phone
- (917) 941-4844
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | Primary |
Addresses
Primary practice location
15012 Roosevelt Ave
Flushing, NY 11354-4936
Mailing address
15012 Roosevelt Ave
Flushing, NY 11354-4936
Phone (917) 563-1214
National Provider Directory
National Provider Directory- Tax ID family
- Evergreen Adult Day Care in New York CN
- Part of
- Evergreen Adult Day Care in New York CN
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Day Care Clinic/Center
- Flushing, NY
- NPI 1649682444
-
- Adult Day Care Clinic/Center
- Flushing, NY
- NPI 1851641500
Locations
15012 Roosevelt Ave
Flushing, NY 11354
Phone (917) 563-1214
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Adult Day Care Clinic/Center
- Flushing, NY
- NPI 1851641500
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759363200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1761091200000",
"number": "1346114352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15012 ROOSEVELT AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113544936",
"telephone_number": "917-563-1214",
"fax_number": "917-563-1187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15012 ROOSEVELT AVE",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113544936",
"telephone_number": "917-563-1214",
"fax_number": "917-563-1187"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVERGREEN ADULT DAY CARE IN NY, INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "EVERGREEN ADULT DAY CARE IN NY, INC",
"enumeration_date": "2025-10-02",
"last_updated": "2025-10-22",
"certification_date": "2025-10-22",
"status": "A",
"authorized_official_last_name": "SHIN",
"authorized_official_first_name": "SO MI",
"authorized_official_title_or_position": "PROGRAM DIRECTOR",
"authorized_official_telephone_number": "917-941-4844"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flushing, NY
- Paul Vincent Castillo Evangelista, P.T.
- Michelle Evans, M.D.
- Sedef Everest, M.D.
- Evergreen Adult Day Care in Flushing Inc
- Evergreen Adult Day Care in New York CN
- Evergreen Adult Day Care in Ny, Inc
- Evergreen Homecare Service of Ny Inc
- Evergreen Optical
- Evergreen Senior Daycare Center Inc
- Everluck Pharmacy Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.