Statewide Detail for Adult Foster Care / Homes for the Aged Facilities

Facility Information
Facility Name:
Evergreen Home
Address:
110 Charlene Drive
Roscommon , MI 48653
County:
ROSCOMMON
Phone:
(989) 821-8533
License Number:
AS720263278
Facility Status:
ACTIVE
License Status:
REGULAR
License Effective Date:
12/1/2022
License Expiration Date:
11/30/2024
License Facility Type:
ADULT SMALL GROUP HOME (CAPACITY 1-6)
Capacity:
6
Services Provided
Serves:
Developmentally Disabled, Physically Handicapped
Special Certification:
Developmentally Disabled
Certification for Community Living:
Licensee Information
Licensee Information:
Northern Lakes Community Mental Health
Suite A
105 Hall Street
Traverse City , MI 49684
Licensee Phone:
(989) 348-0014
Reports Available
AS720263278_RNWL_20220805.pdf
11/25/2022
AS720263278_QUAL.pdf
4/13/2009
AS720263278_ORIG.pdf
6/8/2004

The reports on this site are available for downloading or viewing using the Adobe Acrobat Reader. When rule violations have been cited in a report, the licensee is required to submit a corrective action plan. Written corrective action plans that are submitted by the licensee in response to the Department reports are available through the Freedom of Information Act

  • Original and Renewal Licensing Study Report
    Completed in response to the initial or renewal application for license on all facilities.
  • Inspection Report
    Interim Inspections are conducted at or near the mid point of the effective dates of the license.
  • Special Investigation Report
    Special Investigation Reports are conducted in response to rule related complaints received regarding a facility. The presence of a special investigation report on this site does mean there were substantiated rule violations. Please read any report in its entirety.