EVERGREEN PLACE LLC
NPI 1215456777
Assisted Living Facility in Midvale, UT

Q: What is Evergreen Place LLC's NPI number?

The NPI number for Evergreen Place LLC is 1215456777. It was assigned to this organization in the NPPES registry on September 15, 2017.

Q: What is Evergreen Place LLC's specialty?

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

Active since September 15, 2017

163 E 7800 S, MIDVALE, UT 84047(801) 921-0070 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2018, Sep 18, 2017, Sep 15, 2017 (3 updates tracked since 2017).

On this page

About Evergreen Place Llc NPPES

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

EVERGREEN PLACE LLC (NPI 1215456777) is a healthcare organization registered as an assisted living facility in Midvale, Utah and active in the NPI registry since September 2017. The organization maintains a secondary practice location in West Valley and lists Jorge Gustavo Gonzalez Villarruel, Owner, as its authorized official.

NPPES Registry Identity

NPI1215456777

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameEVERGREEN PLACE LLC

Location Address163 E 7800 SMidvale, UT 84047-2612

Mailing AddressPo Box 9193Midvale, UT 84047-9193 · (801) 921-0070

Phone(801) 921-0070

Organization SubpartNo

Authorized OfficialJorge Gustavo Gonzalez VillarruelOwner · (801) 921-0070

Enumeration DateSeptember 15, 2017

Last NPPES UpdateMarch 17, 20183 updates tracked since enumeration

✔ NPI 1215456777 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.

163 E 7800 S, Midvale, UT 84047

Open in Google Maps ↗

Secondary Practice Location 1

Location 13481 W 3100 SWest Valley, UT 84119-2559 · Phone (801) 921-0070

Other Providers at the Same Location NPPES 2

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

DAISY MAY INC.

Assisted Living Facility

163 E 7800 S
MIDVALE, UT 84047

Salt Lake County (801) 566-6934

DAISYMAYINC

Point of Service

163 E 7800 S
MIDVALE, UT 84047

Salt Lake County (801) 566-6934

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 LLC's NPI number?

The NPI number for Evergreen Place LLC is 1215456777. It was assigned to this organization in the NPPES registry on September 15, 2017.

Where is Evergreen Place LLC located?

Evergreen Place LLC is located at 163 E 7800 S, Midvale, UT 84047. The listed phone number is (801) 921-0070.

What is Evergreen Place 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 LLC was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.