Organization Active NPI

Evergreen Healthcare LLC

  • Home Health Agency
  • Woodbridge, VA
National Provider Identifier
1467314070
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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

Updated by the provider on Dec 2, 2025

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
HCO-0005732OtherVAHCO

Other names 1

  • EVERGREEN HOME HEALTHCARE Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.