NPIMap

Organization Active NPI

Evergreen Senior Day Center

  • Adult Day Care Clinic/Center
  • Columbia, MD
National Provider Identifier
1508057175
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
10599 Issued in MD
Legal business name
EVERGREEN SENIOR DAY CENTER
Practice address
9405 Guilford Rd
Columbia, MD 21046-1911
Phone
(240) 456-0635
Fax
(240) 456-0636
NPI assigned
Aug 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Authorized official

Name
Mrs. Marian D Grenway
Title
Executive Director
Phone
(240) 456-0635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 10599 MD Primary

Addresses

Primary practice location

9405 Guilford Rd
Columbia, MD 21046-1911

Mailing address

9405 Guilford Rd
Columbia, MD 21046-1911
Phone (240) 456-0635

Other identifiers 1

IdentifierTypeStateIssuer
479200900MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Senior Day Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9405 Guilford Rd
Columbia, MD 21046
Phone (240) 456-0635

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1508057175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9405 GUILFORD RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461911",
            "telephone_number": "240-456-0635",
            "fax_number": "240-456-0636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9405 GUILFORD RD",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461911",
            "telephone_number": "240-456-0635",
            "fax_number": "240-456-0636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN SENIOR DAY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "GRENWAY",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "240-456-0635",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MD",
            "license": "10599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "479200900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.