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Evergreen Assisted Living Community Llc
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Roanoke, Virginia
NPI 1780206250

Evergreen Assisted Living Community Llc is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Roanoke, VA. Evergreen Assisted Living Community Llc practices in Roanoke, VA. The NPI Number for Evergreen Assisted Living Community Llc is 1780206250 and holds a License No. (Virginia).

The current practice location address for Evergreen Assisted Living Community Llc is 4222 Moomaw Ave Nw, Roanoke, VA and can be reached out via phone at 540-613-0757 and via fax at 540-491-9319.

Location: 4222 Moomaw Ave Nw, Roanoke, VA, 24017-4314
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1780206250
Provider Name
Evergreen Assisted Living Community Llc
Credential
Provider Entity Type
Organization
Address
4222 Moomaw Ave Nw, Roanoke, VA, 24017-4314
Phone Number
540-613-0757
Fax Number
540-491-9319
Provider Enumeration Date
05/07/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4222 Moomaw Ave Nw
City
Roanoke
State
Virginia
Zip
24017-4314
Phone Number
540-613-0757
Fax Number
540-491-9319
person
Provider Business Mailing Address Details
Address
4222 Moomaw Ave Nw
City
Roanoke
State
Virginia
Zip
24017-4314
Phone Number
540-613-0757
Fax Number
540-491-9319
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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