Evergreen Assisted Living Community LLC
Evergreen Assisted Living Community LLC is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Roanoke, Virginia. Registered with an NPI since 2020.
- In the registry since
- 2020
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
4222 Moomaw Ave NWRoanoke, VA 24017-4314
Phone: (540) 613-0757
Fax: (540) 491-9319
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (primary) | Taxonomy 320900000X |
|---|
Record details
| NPI number | 1780206250 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Patience Odupelu — Owner/ Program Director · (540) 613-0757 |
| Other names | Evergreen Group Home Services |
| NPI enumerated | May 7, 2020 |
| Last updated in NPPES | May 7, 2020 |
| Certification date | May 7, 2020 |
| Mailing address | 4222 Moomaw Ave Nw, Roanoke, VA 24017-4314 |
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