Evergreen Group Home
Evergreen Group Home is an Intellectual Disabilities Intermediate Care Facility in Urbana, Missouri. Licensed in Missouri. Registered with an NPI since 2008.
- Licensed in
- MO
- In the registry since
- 2008
Practice location Address checks out
27 Hopper TrlUrbana, MO 65767-9234
Phone: (417) 722-4416
Fax: (417) 722-4417
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual Disabilities Intermediate Care Facility (primary) | Taxonomy 315P00000X · Licence LC0556542 (MO) |
|---|
Record details
| NPI number | 1841452109 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Gary Boggs — Director · (417) 722-4416 |
| Other names | Pineview Group Home |
| NPI enumerated | June 27, 2008 |
| Last updated in NPPES | June 27, 2008 |
| Mailing address | 27 Hopper Trl, Urbana, MO 65767-9234 |
Other providers in Urbana
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Applewood Lane Corporation
27 Hopper Trl, Urbana, MO 65767-9234 · (417) 722-4416