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EVERGREEN PLACE LLC
NPI 1487164505
Assisted Living Facility in West Valley City, UT

Active since October 03, 2017
3481 W 3100 S, WEST VALLEY CITY, UT 84119(801) 921-0070 Get Directions Write a Review

NPPES record last updated: October 3, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Evergreen Place Llc NPPES

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

EVERGREEN PLACE LLC (NPI 1487164505) is a healthcare organization registered as an assisted living facility in West Valley City, Utah and active in the NPI registry since October 2017. The organization lists Jorge Gustavo Gonzalez Villarruel, Owner, as its authorized official.

NPPES Registry Identity

NPI1487164505
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameEVERGREEN PLACE LLC
Location Address3481 W 3100 SWest Valley City, UT 84119-2559
Mailing AddressPo Box 9193Midvale, UT 84047-9193
Phone(801) 921-0070
Organization SubpartYesParent: 82230602
Authorized OfficialJorge Gustavo Gonzalez VillarruelOwner · (801) 921-0070
Enumeration DateOctober 3, 2017
✔ NPI 1487164505 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.
3481 W 3100 S, West Valley City, UT 84119
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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 1487164505. It was assigned to this organization in the NPPES registry on October 3, 2017.

Where is Evergreen Place LLC located?

Evergreen Place LLC is located at 3481 W 3100 S, West Valley City, UT 84119. 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 October 3, 2017. 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.