Evergreen Commons, Inc.

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

EVERGREEN COMMONS, INC.

Doing business as

Evergreen Commons Senior Center

Practice address

480 State St
Holland, MI 49423-4832

Phone

(616) 396-7100

Fax

(616) 396-9736

NPI assigned

May 14, 2007

Last updated

Dec 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Suzzanne Sholes

Title

Director of the Day Center

Phone

(269) 352-9029

Specialties & licenses 2

Addresses

Other names 2

• Evergreen Commons Senior Center Doing business as
• Holland Senior Citizens Center Former legal business name

Locations

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1861607517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 STATE ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234832",
            "telephone_number": "616-396-7100",
            "fax_number": "616-396-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 STATE ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234832",
            "telephone_number": "616-396-7100",
            "fax_number": "616-396-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN COMMONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "SHOLES",
        "authorized_official_first_name": "SUZZANNE",
        "authorized_official_title_or_position": "DIRECTOR OF THE DAY CENTER",
        "authorized_official_telephone_number": "269-352-9029",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Commons Senior Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evergreen Commons Senior Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Holland Senior Citizens Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.