Organization · Type 2 NPI

Evergreen Road Facility

Intellectual and/or Developmental Disabilities Residential Treatment Facility · Rocky Mount, NC

NPI number 1043409584 Active

Practice location

827 Evergreen Rd
Rocky Mount, NC 27803-2426

Call (252) 446-8675 Map

Mailing address

7227 Lee Deforest Dr
Columbia, MD 21046-3236

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary 320600000X064-079 (NC)

Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

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About NPI 1043409584

Evergreen Road Facility's National Provider Identifier is 1043409584, issued on Oct 22, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Rocky Mount, NC. The record was last updated on Oct 22, 2007.