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EVERGREEN LITCHFIELD L.P. NPI 1376798777


NPI Information

NPI: 1376798777
Provider Name: EVERGREEN LITCHFIELD, L.P.

Doing Business As: EVERGREEN PLACE OF LITCHFIELD SUPPORTIVE LIVING

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 14D2194854

Address:
1015 E. TYLER AVE
LITCHFIELD, IL
ZIP 62056
Phone: (217) 324-1500
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EVERGREEN LITCHFIELD, L.P. is an assisted living facility in Litchfield, IL. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. EVERGREEN LITCHFIELD, L.P. NPI is 1376798777. The provider is registered as an organization entity type.
The provider Is Doing Business As Evergreen Place Of Litchfield Supportive Living.

The provider's business location address is:

1015 E. TYLER AVE
LITCHFIELD, IL
ZIP 62056-716
Phone: (217) 324-1500
Fax: (317) 324-6020

The provider's authorized official is Craig L. Ater .
The authorized official title is Senioe V.p. Of Finance and has the following contact phone number (309) 828-4361.

The CLIA number assigned to this NPI record is 14D2194854 - other - supportive living fac with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/26/2008 and was last updated on 11/26/2008.


Taxonomy Codes

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

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: 5/5/2024

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