EVERGREEN PLACE LLC NPI 1215456777

NPI Information

EVERGREEN PLACE LLC is an assisted living facility in Midvale, UT. The provider is 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. EVERGREEN PLACE LLC NPI is 1215456777. The provider is registered as an organization entity type.

The provider's business location address is:

163 E 7800 S
MIDVALE, UT
ZIP 84047-612
Phone: (801) 921-0070

The provider's authorized official is Jorge Gustavo Gonzalez Villarruel .
The authorized official title is Owner and has the following contact phone number (801) 921-0070.

The enumeration date for this NPI number is 9/15/2017 and was last updated on 3/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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