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Contact Information

EVERGREEN HOME HEALTH CARE LLC
5980 S MAIN ST
SUITE 102
CLARKSTON, MI48346
 Phone: 248-620-1211
 Fax: 248-620-1214
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Home Health

251E00000X A4[11] Home Health Agency
Indicates primary specialty

NPI Profile & details for EVERGREEN HOME HEALTH CARE LLC

NPI # 1174526453
LBN Legal business name EVERGREEN HOME HEALTH CARE LLC
Authorized official RICHARD KELTERBORN - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 05/31/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
MI License # MI638061
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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