EVERGREEN RESIDENTIAL CARE
NPI 1487719662
Assisted Living Facility in Salt Lake City, UT

Q: What is Evergreen Residential Care's NPI number?

The NPI number for Evergreen Residential Care is 1487719662. It was assigned to this organization in the NPPES registry on December 27, 2006.

Q: What is Evergreen Residential Care's specialty?

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

Active since December 27, 2006

2374 EVERGREEN AVE, SALT LAKE CITY, UT 84109(801) 272-2601(801) 278-3697 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Evergreen Residential Care NPPES

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

EVERGREEN RESIDENTIAL CARE (NPI 1487719662) is a healthcare organization registered as an assisted living facility in Salt Lake City, Utah and active in the NPI registry since December 2006. The organization lists Melvin Darcy Forsman, Owner, as its authorized official.

NPPES Registry Identity

NPI1487719662

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameEVERGREEN RESIDENTIAL CARE

Location Address2374 EVERGREEN AVESalt Lake City, UT 84109-3006

Mailing Address2374 Evergreen AveSalt Lake City, UT 84109-3006 · (801) 272-2601 · Fax (801) 278-3697

Phone(801) 272-2601

Fax(801) 278-3697

Organization SubpartNo

Authorized OfficialMelvin Darcy ForsmanOwner · (801) 272-2601

Enumeration DateDecember 27, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1487719662 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

License✔ Licensed in UT · 2919

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.

2374 EVERGREEN AVE, Salt Lake City, UT 84109

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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 Residential Care's NPI number?

The NPI number for Evergreen Residential Care is 1487719662. It was assigned to this organization in the NPPES registry on December 27, 2006.

Where is Evergreen Residential Care located?

Evergreen Residential Care is located at 2374 Evergreen Ave, Salt Lake City, UT 84109. The listed phone number is (801) 272-2601.

What is Evergreen Residential Care'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 Residential Care was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.