Provider Demographics
NPI:1154629012
Name:EVERGREEN ADULT DAY CARE CENTER, INC.
Entity type:Organization
Organization Name:EVERGREEN ADULT DAY CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:AMATO
Authorized Official - Suffix:
Authorized Official - Credentials:CPA, MBA, LNHA
Authorized Official - Phone:518-691-1416
Mailing Address - Street 1:131 LAWRENCE STREET
Mailing Address - Street 2:ATTENTION: BUSINESS OFFICE
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866
Mailing Address - Country:US
Mailing Address - Phone:518-587-3600
Mailing Address - Fax:518-587-2930
Practice Address - Street 1:131 LAWRENCE ST
Practice Address - Street 2:ATTN: BUSINESS OFFICE
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-1346
Practice Address - Country:US
Practice Address - Phone:518-587-3600
Practice Address - Fax:518-587-2930
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED METHODIST HEALTH AND HOUSING, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care