Evergreen Personal Services, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

EVERGREEN PERSONAL SERVICES, LLC

Practice address

5980 S Main St
Suite 101
Clarkston, MI 48346-2377

Phone

(248) 620-8890

Fax

(248) 620-2286

NPI assigned

Apr 20, 2007

Organization subpart

No

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

Authorized official

Name

Janis E Kelterborn, RN

Title

Administrator-Owner

Phone

(248) 620-8890

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386862043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5980 S MAIN ST",
            "address_2": "SUITE 101",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462377",
            "telephone_number": "248-620-8890",
            "fax_number": "248-620-2286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5980 S MAIN ST",
            "address_2": "SUITE 101",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483462377",
            "telephone_number": "248-620-8890",
            "fax_number": "248-620-2286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PERSONAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELTERBORN",
        "authorized_official_first_name": "JANIS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR-OWNER",
        "authorized_official_telephone_number": "248-620-8890",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.