Active NPI
Evergreen Healthcare LLC
- Home Health Agency
- Woodbridge, VA
National Provider Identifier
1467314070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- EVERGREEN HEALTHCARE LLC
- Practice address
- 3115 Golansky Blvd
Woodbridge, VA 22192-4223 - Phone
- (571) 295-3879
- NPI assigned
- Dec 2, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Elsie Adonteng-Boateng
- Title
- Director of Operations
- Phone
- (571) 295-3879
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary | ||
| In Home Supportive Care Agency | 253Z00000X | |||
| Respite Care | 385H00000X |
Addresses
Primary practice location
3115 Golansky Blvd
Woodbridge, VA 22192-4223
Mailing address
3115 Golansky Blvd
Woodbridge, VA 22192-4223
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HCO-0005732 | Other | VA | HCO |
Other names 1
- EVERGREEN HOME HEALTHCARE
National Provider Directory
National Provider DirectoryLocations
3115 Golansky Blvd
Woodbridge, VA 22192
Phone (571) 295-3879
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764633600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1764633600000",
"number": "1467314070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3115 GOLANSKY BLVD",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221924223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3115 GOLANSKY BLVD",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221924223",
"telephone_number": "571-295-3879"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVERGREEN HEALTHCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-12-02",
"last_updated": "2025-12-02",
"certification_date": "2025-12-02",
"status": "A",
"authorized_official_last_name": "ADONTENG-BOATENG",
"authorized_official_first_name": "ELSIE",
"authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
"authorized_official_telephone_number": "571-295-3879"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HCO",
"identifier": "HCO-0005732",
"state": "VA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "EVERGREEN HOME HEALTHCARE",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 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.