| Organization Name: | EVERGREEN HOSPICE AND PALLIATIVE CARE |
| NPI Number: | 1841696911 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARC ALAN BAUDER (CHIEF MEDICAL DIRECTOR) |
| Mailing Address: | 454 W White Mountain Blvd Suite 7 Lakeside |
| State: | AZ US |
| Postal Code: | 859296663 |
| Phone Number: | 6025491905 |
| Fax Number: | 8884327480 |
| NPI Enumeration Date: | 11/17/2014 |
| NPI Last Update Date: | 11/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |