1. Home
  2. Directory
  3. Kansas
  4. Baxter Springs
  5. Assisted Living Facility
  6. NPI Profile

EVERGREEN HAVEN LLC
NPI 1104616002
Assisted Living Facility in Baxter Springs, KS

Active since May 12, 2025
445 E 10TH ST, BAXTER SPRINGS, KS 66713(620) 304-2108(620) 304-2109 Get Directions Write a Review

NPPES record last updated: May 12, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Evergreen Haven Llc NPPES

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

EVERGREEN HAVEN LLC (NPI 1104616002) is a healthcare organization registered as an assisted living facility in Baxter Springs, Kansas and active in the NPI registry since May 2025. The organization lists Larry Robert Higginbotham, Owner, as its authorized official.

NPPES Registry Identity

NPI1104616002
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEVERGREEN HAVEN LLC
Location Address445 E 10TH STBaxter Springs, KS 66713-1614
Mailing AddressPo Box 92Racine, MO 64858-0092 · (417) 850-3063 · Fax (620) 304-2109
Phone(620) 304-2108
Fax(620) 304-2109
Organization SubpartNo
Authorized OfficialLarry Robert HigginbothamOwner · (417) 850-3063
Enumeration DateMay 12, 2025
NPPES CertifiedMay 12, 2025
✔ NPI 1104616002 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.
445 E 10TH ST, Baxter Springs, KS 66713
Open in Google Maps ↗

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEGACY LIVING
Custodial Care Facility (Adult Care Home)
445 E 10TH ST
BAXTER SPRINGS, KS 66713
Cherokee County (620) 856-2756
MRS. CRYSTAL MARIE TAYLOR ARNP
Nurse Practitioner (Family)
445 E 10TH ST
BAXTER SPRINGS, KS 66713
Cherokee County (620) 856-3469
BURDEN MEDICAL CLINIC LLC
Clinic/Center
445 E 10TH ST
BAXTER SPRINGS, KS 66713
Cherokee County (620) 856-3469
TYSON L. BURDEN M.D.
Internal Medicine
445 E 10TH ST
BAXTER SPRINGS, KS 66713
Cherokee County (620) 856-3469
EVERGREEN LIVING LLC
Custodial Care Facility (Adult Care Home)
445 E 10TH ST
BAXTER SPRINGS, KS 66713
Cherokee County (620) 856-2756
ST. JOHN'S MEDICAL GROUP
Clinic/Center (Rural Health)
445 E 10TH ST
BAXTER SPRINGS, KS 66713
Cherokee County (620) 856-3469

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 Haven LLC's NPI number?

The NPI number for Evergreen Haven LLC is 1104616002. It was assigned to this organization in the NPPES registry on May 12, 2025.

Where is Evergreen Haven LLC located?

Evergreen Haven LLC is located at 445 E 10th St, Baxter Springs, KS 66713. The listed phone number is (620) 304-2108.

What is Evergreen Haven 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 Haven LLC was last updated on May 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.