EVERGREEN PLACE LLC – Assisted Living Facility, NPI 1215456777

EVERGREEN PLACE LLC is a healthcare provider. based in Midvale, Utah. specializing in Assisted Living Facility. The NPI Number for EVERGREEN PLACE LLC is 1215456777

Main info

Organization
Name
EVERGREEN PLACE LLC
NPI
1215456777
Phone
(801) 921-0070
Address
PO BOX 9193
Authorized Official
JORGE GUSTAVO GONZALEZ VILLARRUEL OWNER
Enumeration Date
15 September 2017
Last Update Date
17 March 2018
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness75
Years active:8State licenses:0Digital endpointsOther names

Provider Addresses for EVERGREEN PLACE LLC

  • PO BOX 9193

    MIDVALE, UT 840479193

    Phone: (801) 921-0070

    Type: Mailing

  • 3481 W 3100 S

    West Valley, UT 841192559

    Phone: (801) 921-0070

    Type: Location

  • 163, 7800 South, Midvale, Salt Lake County, Utah, 84047, United States

    MIDVALE, UT 840472612

    Phone: (801) 921-0070

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84047)

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Reviews

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Frequently asked questions

Can I verify EVERGREEN PLACE LLC with an NPI only?
You can start verification with NPI 1215456777 for EVERGREEN PLACE LLC, then check state licensing separately.
Can I rely on EVERGREEN PLACE LLC being an active provider?
As of the registry snapshot, EVERGREEN PLACE LLC is marked active.
What taxonomy line describes EVERGREEN PLACE LLC?
For research purposes, treat EVERGREEN PLACE LLC as Assisted Living Facility in this dataset. Clinical services aligned with this taxonomy classification.
Where is EVERGREEN PLACE LLC based?
EVERGREEN PLACE LLC is tied to Midvale, Utah in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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