Evergreen Caregivers, Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

EVERGREEN CAREGIVERS, INC.

Practice address

846 W Palmdale Blvd
Palmdale, CA 93551-4250

Phone

(661) 310-1989

Fax

(661) 888-5821

NPI assigned

Dec 21, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Paul Lynn Wilson, CHAA

Title

Ceo

Phone

(661) 310-1989

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513814400000",
    "number": "1629584081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38713 TIERRA SUBIDA AVE STE 200-126",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514562",
            "telephone_number": "661-310-1989",
            "fax_number": "661-888-5821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "846 W PALMDALE BLVD",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935514250",
            "telephone_number": "661-310-1989",
            "fax_number": "661-888-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN CAREGIVERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-21",
        "last_updated": "2017-12-21",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "661-310-1989",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CHAA"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Palmdale, CA
• Providers in Palmdale, CA by specialty
• In Home Supportive Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; 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.