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EVERGREEN LIVING HOME #12
NPI 1811018674
Custodial Care Facility - Adult Care Home in Leicester, NC

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

NPPES record last updated: September 8, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 8, 2023, Aug 22, 2020 (2 updates tracked since 2020).

About Evergreen Living Home #12 NPPES

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

EVERGREEN LIVING HOME #12 (NPI 1811018674) 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 Song Lee, Owner, as its authorized official.

NPPES Registry Identity

NPI1811018674
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameEVERGREEN LIVING HOME INC.
Location Address353 FAMILY RIDGE ROADLeicester, NC 28748
Mailing AddressPo Box 2077Leicester, NC 28748-2077 · (828) 779-5588
Phone(828) 779-5588
Organization SubpartNo
Authorized OfficialYoung Song LeeOwner · (828) 779-5588
Enumeration DateApril 2, 2007
Last NPPES UpdateSeptember 8, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 8, 2023
✔ NPI 1811018674 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-011-198
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.
353 FAMILY RIDGE ROAD, Leicester, NC 28748
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Other Names 1

Doing Business AsEvergreen Living Home #12

Other Identifiers 1

Medicaid7805219NC

Other Providers at the Same Location NPPES

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

EVERGREEN LIVING HOME INC.
Custodial Care Facility (Adult Care Home)
353 FAMILY RIDGE ROAD
LEICESTER, NC 28748
Buncombe County (828) 779-5588

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 Home Inc.'s NPI number?

The NPI number for Evergreen Living Home Inc. is 1811018674. It was assigned to this organization in the NPPES registry on April 2, 2007. The provider is doing business as Evergreen Living Home #12.

Where is Evergreen Living Home Inc. located?

Evergreen Living Home Inc. is located at 353 Family Ridge Road, Leicester, NC 28748. The listed phone number is (828) 779-5588.

What is Evergreen Living Home Inc.'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 Home Inc. was last updated on September 8, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.