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EVERGREEN PLACE DECATUR SUPPORTIVE LIVING
NPI 1003188913
Assisted Living Facility in Decatur, IL

Active since February 08, 2012
4825 E EVERGREEN COURT, DECATUR, IL 62521(217) 864-4300(217) 864-4321 Get Directions Write a Review

NPPES record last updated: February 17, 2012. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Evergreen Place Decatur Supportive Living NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN PLACE DECATUR SUPPORTIVE LIVING (NPI 1003188913) is a healthcare organization registered as an assisted living facility in Decatur, Illinois and active in the NPI registry since February 2012. The organization lists Craig L Ater, Exec Vp & Cfo, as its authorized official.

NPPES Registry Identity

NPI1003188913
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEVERGREEN PLACE DECATUR, LLC
Location Address4825 E EVERGREEN COURTDecatur, IL 62521
Mailing Address115 W Jefferson St Ste 401Bloomington, IL 61701-3967 · (309) 823-7155 · Fax (309) 829-9512
Phone(217) 864-4300
Fax(217) 864-4321
Organization SubpartNo
Authorized OfficialCraig L AterExec Vp & Cfo · (309) 823-7135
Enumeration DateFebruary 8, 2012
Last NPPES UpdateFebruary 17, 2012
✔ NPI 1003188913 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
4825 E EVERGREEN COURT, Decatur, IL 62521
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Other Names 1

Doing Business AsEvergreen Place Decatur Supportive Living

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evergreen Place Decatur, LLC's NPI number?

The NPI number for Evergreen Place Decatur, LLC is 1003188913. It was assigned to this organization in the NPPES registry on February 8, 2012. The provider is doing business as Evergreen Place Decatur Supportive Living.

Where is Evergreen Place Decatur, LLC located?

Evergreen Place Decatur, LLC is located at 4825 E Evergreen Court, Decatur, IL 62521. The listed phone number is (217) 864-4300.

What is Evergreen Place Decatur, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Evergreen Place Decatur, LLC was last updated on February 17, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.