EVERGREEN HOME CARE LLC (NPI# 1104946508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104946508 |
| Entity Type | Organization |
| Organization Name | EVERGREEN HOME CARE LLC |
| Practice Address |
1663 Stephenson Hwy Suite 200 Troy MI 48083-2169 |
| Practice Telephone | 2482915806 |
| Practice Fax Number | 2482916847 |
| Mailing Telephone | 2482915806 |
| Mailing Fax Number | 2482916847 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2014-08-20 |
| Authorized Official Name | MRS. PURVI SHAH (OWNER) |
| Authorized Official Telephone | 2482915806 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | EVERGREEN HOME CARE LLC | 20 Bernardino Ave, Enfield, CT 06082 |
| New York State Corporations | EVERGREEN HOME CARE LLC | 1303 53rd Street, Suite 308, Brooklyn, Ny 11219 |
| Street Address |
1663 STEPHENSON HWY SUITE 200 |
| City | TROY |
| State | MI |
| Zip Code | 48083-2169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245876697 | Marylou Joseph | Physical Therapy Assistant | 1663 Stephenson Hwy, Troy, MI 48083-2169 | 2019-11-20 |
| 1629610613 | Julie West | Registered Nurse | 1663 Stephenson Hwy, Troy, MI 48083-2169 | 2019-10-11 |
| 1265074561 | Kajal Patel | Registered Nurse | 1663 Stephenson Hwy, Troy, MI 48083-2169 | 2019-10-08 |
| 1760032882 | Care Assist Homecare LLC | Home Health | 1663 Stephenson Hwy, Troy, MI 48083-2169 | 2019-09-19 |
| 1306404512 | Masashi Mizobuchi | Occupational Therapist | 1663 Stephenson Hwy, Troy, MI 48083-2169 | 2019-06-03 |
| 1396205415 | Angela Kejbou | Occupational Therapist | 1663 Stephenson Hwy, Troy, MI 48083-2169 | 2019-03-24 |
| 1093286056 | Harsh M Thakore | Physical Therapist | 1663 Stephenson Hwy, Troy, MI 48083-2169 | 2018-12-16 |
| 1083185664 | Melissa Ann Cesario | Occupational Therapist | 1663 Stephenson Hwy, Troy, MI 48083-2169 | 2018-12-07 |
| 1508337395 | Michelle Elizabeth Polec | Occupational Therapist | 1663 Stephenson Hwy, Troy, MI 48083-2169 | 2018-12-06 |
| 1578034351 | Christopher Rowe | Occupational Therapist | 1663 Stephenson Hwy, Troy, MI 48083-2169 | 2018-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417420449 | Thapasvi Muttirevula | Physical Therapist | 2422 Cedar Knoll Dr, Troy, MI 48083 | 2019-01-02 |
| 1114418290 | Ann Katchke | Physical Therapist | 3179 Livernois Rd, Troy, MI 48083 | 2018-05-23 |
| 1518485945 | Risa Rae Mendelson | Counselor | 1059 Owendale Street, Troy, MI 48083 | 2017-09-06 |
| 1497277115 | Gassan Asadi | Pharmacist | 215 E Big Beaver Rd Ste 500, Troy, MI 48083 | 2017-07-14 |
| 1528510328 | Dylan Skye Polasko | Behavioral Analyst | 2221 E 4th St, #101, Troy, MI 48083 | 2016-10-27 |
| 1235683061 | Sadia Ghazi | Technician, Other | 3178 Daley Dr., Troy, MI 48083 | 2016-08-10 |
| 1548664345 | Amber Leigh Ernst | Social Worker | 1225 E. Big Beaver Road, Troy, MI 48083 | 2014-10-22 |
| 1356782411 | Michelle Louise Knoblock | Nurse Anesthetist, Certified Registered | 1560 E Maple Rd Ste 100, Troy, MI 48083 | 2013-07-17 |
| 1437400728 | Oakland Physicians Surgery Center | Clinic/Center | 1560 E. Maple Road, Suite 100, Troy, MI 48083 | 2012-09-26 |
| 1861748238 | Pro Med Substance Abuse Program LLC | Psychologist | 2891 E. Maple Rd. Suite 200, Troy, MI 48083 | 2012-08-03 |
| Find all providers in zip 48083 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811504251 | Jennifer K Persinger | Home Health | 1330 Wright Cir, Troy, OH 45373-1632 | 2020-09-29 |
| 1881202414 | Ann Chambers | Home Health | 1320 Dry Creek Rd, Troy, ID 83871-9664 | 2020-07-20 |
| 1689282758 | Care Continuum Home Health Services LLC | Home Health | 671 E Big Beaver Rd Ste 207a, Troy, MI 48083-1422 | 2020-07-15 |
| 1588223481 | Biomatrix Wholesale Services LLC | Home Health | 1116 E Big Beaver Rd, Troy, MI 48083-1934 | 2019-06-13 |
| 1407365000 | A New Beginning for You, Inc. | Home Health | 609 North 3 Notch Street, Troy, AL 36081-0193 | 2017-09-26 |
| 1477094506 | Carla Oiler | Home Health | 2728 Fairview Ct, Troy, OH 45373-8900 | 2017-03-08 |
| 1689120297 | Arch Home Care | Home Health | 2820 S. County Line Rd 25a, Troy, OH 45377 | 2016-09-01 |
| 1013374107 | Wellness Home Care | Home Health | 751 Coachman Dr, Apt 1, Troy, MI 48083-1541 | 2016-01-21 |
| 1336513829 | Mm Faith Corp | Home Health | 560 Kirts Blvd Ste 106, Troy, MI 48084-4141 | 2015-11-20 |
| 1174995633 | Carolinas Medical Center At Home, LLC | Home Health | 1061 Albemarle Rd, Troy, NC 27371-8684 | 2015-10-23 |
| Find all providers in TROY | ||||
Please comment or provide details below to improve the information on EVERGREEN HOME CARE LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.