NPI 1558015248

Evergreen Congregate, LLC

Organisation Physical Disabilities Residential Treatment Facility Costa Mesa, CA

Practice location

Address: 823 Towne St, Costa Mesa, CA 92627-3509
Phone: (949) 397-0658
Mailing address: 27702 Crown Valley Pkwy, Ladera Ranch, CA 92694-0608

Authorised official

Name: Adam Cortland Green
Title: Owner
Phone: (949) 397-0658

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X

Other Residential Treatment Facility, Physical Disabilities providers in California →

Registry record

NPI: 1558015248
Entity type: Organization
NPI issued: 10 Feb 2022
Record last updated: 10 Feb 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.