EVERGREEN CONGREGATE, LLC is a residential treatment facility physical disabilities in Costa Mesa, CA. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently. EVERGREEN CONGREGATE, LLC NPI is 1558015248. The provider is registered as an organization entity type.
The provider's business location address is:
823 TOWNE ST COSTA MESA, CA ZIP 92627-509 Phone: (949) 397-0658
The provider's authorized official is Adam Cortland Green . The authorized official title is Owner and has the following contact phone number (949) 397-0658.
The CLIA number assigned to this NPI record is 05D2326693 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 2/10/2022 and was last updated on 2/10/2022.
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:
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.
This page was last updated on: 11/21/2025
NPI Synchronization or Removal
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