Organization Name: | EVERGREEN HOSPICE LLC |
NPI Number: | 1740339548 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATHERINE MICHELLE NORTON (EXECUTIVE DIRECTOR) |
Mailing Address: | 9902 E 43rd St Suite B Tulsa |
State: | OK US |
Postal Code: | 741464756 |
Phone Number: | 9182505555 |
Fax Number: | |
NPI Enumeration Date: | 01/09/2007 |
NPI Last Update Date: | 02/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 4194 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |