EVERGREEN PLACE LLC – Assisted Living Facility, NPI 1487164505

EVERGREEN PLACE LLC is a healthcare provider. based in Midvale, Utah. specializing in Assisted Living Facility. The NPI Number for EVERGREEN PLACE LLC is 1487164505

Main info

Organization
Name
EVERGREEN PLACE LLC
NPI
1487164505
Phone
Not provided
Address
PO BOX 9193
Authorized Official
JORGE GUSTAVO GONZALEZ VILLARRUEL OWNER
Enumeration Date
3 October 2017
Last Update Date
3 October 2017
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:

    Type: Mailing

  • 3481 W 3100 S

    WEST VALLEY CITY, UT 841192559

    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.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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

Is EVERGREEN PLACE LLC listed with a National Provider Identifier?
Yes — EVERGREEN PLACE LLC has NPI 1487164505 on file in the registry.
Active or inactive — what applies to EVERGREEN PLACE LLC?
You should see EVERGREEN PLACE LLC as active in CMS-hosted NPPES data.
How would a patient describe EVERGREEN PLACE LLC's focus?
For EVERGREEN PLACE LLC, the primary taxonomy reads as Assisted Living Facility. Clinical services aligned with this taxonomy classification.
Where in Utah is EVERGREEN PLACE LLC registered?
Use Midvale, Utah as the headline location for EVERGREEN PLACE LLC here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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