EVERGREEN LIVING #4
NPI 1255452017
Custodial Care Facility - Adult Care Home in Leicester, NC

Active since April 02, 2007
351 FAMILY RIDGE ROAD, LEICESTER, NC 28748(828) 779-5588 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Evergreen Living #4 NPPES

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

EVERGREEN LIVING #4 (NPI 1255452017) is a healthcare organization registered as an adult care home in Leicester, North Carolina and active in the NPI registry since April 2007. The organization lists Young S Lee, Owner, as its authorized official.

NPPES Registry Identity

NPI1255452017
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameEVERGREEN LIVING #4
Location Address351 FAMILY RIDGE ROADLeicester, NC 28748
Mailing AddressPo Box 2077Leicester, NC 28748-2077 · (828) 779-5588
Organization SubpartNo
Authorized OfficialYoung S LeeOwner · (828) 779-5588
Enumeration DateApril 2, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1255452017 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
License Licensed in NC · FCL-011-196
Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

351 FAMILY RIDGE ROAD, Leicester, NC 28748

Other Identifiers 1

Medicaid7805221NC

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.

Custodial Care Facility (Adult Care Home)
351 FAMILY RIDGE ROAD
LEICESTER, NC 28748
Custodial Care Facility (Adult Care Home)
351 FAMILY RIDGE ROAD
LEICESTER, NC 28748

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 Living #4's NPI number?

The NPI number for Evergreen Living #4 is 1255452017. It was assigned to this organization in the NPPES registry on April 2, 2007.

Where is Evergreen Living #4 located?

Evergreen Living #4 is located at 351 Family Ridge Road, Leicester, NC 28748. The listed phone number is (828) 779-5588.

What is Evergreen Living #4's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

When was this NPI record last updated?

The NPPES record for Evergreen Living #4 was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.