Provider Demographics
NPI:1750577110
Name:EVERGREEN WORLD ADHC
Entity type:Organization
Organization Name:EVERGREEN WORLD ADHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHIA L.
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-638-1818
Mailing Address - Street 1:9856 WESTMINSTER AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92844-2907
Mailing Address - Country:US
Mailing Address - Phone:714-638-1818
Mailing Address - Fax:714-638-3828
Practice Address - Street 1:9113 BOLSA AVE STE 228
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-1303
Practice Address - Country:US
Practice Address - Phone:714-638-1818
Practice Address - Fax:714-638-3828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care