National Provider Identifier Database

EVERGREEN COMMUNITY HOMES INC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities


Contact Information

EVERGREEN COMMUNITY HOMES INC
13 BROADBRIDGE RD
ROSEDALE, MD21237-1558
Phone: 443-642-9933
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320900000X

* Indicates primary specialty

NPI Profile & details for EVERGREEN COMMUNITY HOMES INC

NPI Number 1205589173
Legal business name
LBN
EVERGREEN COMMUNITY HOMES INC
Authorized official NGOZI WILKENS - (ADMINISTRATOR)
Entity Organization
Organization subpart No
Enumeration date 02/01/2022
Last updated 02/01/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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