Evergreen Place LLC
NPI 1215456777ActiveOrganization· Assisted Living Facility· Midvale, UT
Assisted Living Facility in Midvale, Utah, registered in NPPES in September 2017. The authorized official on file is Jorge Gustavo Gonzalez Villarruel, Owner.
Overview
| NPI | 1215456777 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 15, 2017 |
| Last updated in NPPES | Mar 17, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Assisted Living Facility Primary | 310400000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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