EVERGREEN LIVING HOME #4 (NPI# 1427255264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427255264 |
| Entity Type | Organization |
| Organization Name | EVERGREEN LIVING HOME #4 |
| Practice Address |
230 Country Time Circle Leicester NC 28748 |
| Mailing Address |
Po Box 1808 Leicester NC 28748-1808 |
| Practice Telephone | 8286838884 |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. LINDA LEA (ADMINISTRATOR) |
| Authorized Official Telephone | 8282799592 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | FCL-011-248 | NC | Nursing & Custodial Care Facilities |
| Street Address |
230 COUNTRY TIME CIRCLE |
| City | LEICESTER |
| State | NC |
| Zip Code | 28748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609997519 | Evergreen Living #4 | Custodial Care Facility | 230 Country Time Circle, Leicester, NC 28748 | 2007-04-02 |
| 1366824195 | Smith Street Village Family Care Home, LLC | Custodial Care Facility | 230 Country Time Circle, Leicester, NC 28748-6213 | 2015-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659494300 | Evergreen Living #5 | Custodial Care Facility | 352 Family Ridge Road, Leicester, NC 28748 | 2007-04-09 |
| 1346361102 | Evergreen Living #1 | Custodial Care Facility | 101 Country Time Ln, Leicester, NC 28748 | 2007-04-02 |
| 1811018674 | Evergreen Living #6 | Custodial Care Facility | 353 Family Ridge Road, Leicester, NC 28748 | 2007-04-02 |
| 1053431957 | Evergreen Living #5 | Custodial Care Facility | 231 Country Time Circle, Leicester, NC 28748 | 2007-04-02 |
| 1962522862 | Evergreen Living #6 | Custodial Care Facility | 232 Country Time Circle, Leicester, NC 28748 | 2007-04-02 |
| 1639290497 | Evergreen Living #7 | Custodial Care Facility | 233 Country Time Circle, Leicester, NC 28748 | 2007-04-02 |
| 1548381304 | Evergreen Living #8 | Custodial Care Facility | 234 Country Time Circle, Leicester, NC 28748 | 2007-04-02 |
| 1457472219 | Evergreen Living #9 | Custodial Care Facility | 235 Country Time Circle, Leicester, NC 28748 | 2007-04-02 |
| 1295856052 | Evergreen Living #10 | Custodial Care Facility | 236 Country Time Circle, Leicester, NC 28748 | 2007-04-02 |
| 1861512972 | Evergreen Living #3 | Custodial Care Facility | 103 Country Time Ln, Leicester, NC 28748 | 2007-03-30 |
| Find all providers in zip 28748 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154579670 | Wnc Family Care Homes, Inc | Assisted Living Facility | 233 Country Time Ln, Leicester, NC 28748-6213 | 2008-09-09 |
| 1720235302 | Wnc Family Care Homes, Inc | Assisted Living Facility | 231 Country Time Ln, Leicester, NC 28748-6213 | 2008-08-26 |
| 1225285869 | Wnc Family Care Homes Inc | Assisted Living Facility | 232 Country Time Ln, Leicester, NC 28748-6213 | 2008-08-26 |
| 1801043484 | Wnc Family Care Homes, Inc | Assisted Living Facility | 235 Country Time Ln, Leicester, NC 28748-6213 | 2008-08-26 |
| 1942457643 | Wnc Family Care Homes, Inc | Assisted Living Facility | 234 Country Time Ln, Leicester, NC 28748-6213 | 2008-08-25 |
| 1730336736 | Wnc Family Care Homes, Inc | Assisted Living Facility | 230 Country Time Ln, Leicester, NC 28748-6213 | 2008-08-20 |
| 1720537582 | Soundview Family Care Homes | Assisted Living Facility | 233 Country Time Ln, Leicester, NC 28748-6213 | 2016-09-22 |
| 1902355761 | Soundview Family Care Homes | Assisted Living Facility | 232 Country Time Ln, Leicester, NC 28748-6213 | 2016-09-22 |
| 1700331642 | Soundview Family Care Homes | Assisted Living Facility | 231 Country Time Ln, Leicester, NC 28748-6213 | 2016-08-21 |
| 1245518042 | Soundview Family Care Homes, Inc | Assisted Living Facility | 230 Country Time Ln, Leicester, NC 28748-6213 | 2011-07-27 |
| Find all providers in LEICESTER | ||||
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| 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.