| Evergreen Pathways Home Llc | |
|
3500 Grove City Rd Grove City OH 43123-2598 | |
| (614) 230-7005 | |
| Not Available |
| Full Name | Evergreen Pathways Home Llc |
|---|---|
| Speciality | Psychologist - Intellectual & Developmental Disabilities |
| Location | 3500 Grove City Rd, Grove City, Ohio |
| Authorized Official Name and Position | Laila Mohamed (CEO) |
| Authorized Official Contact | 6142307005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Pathways Home Llc 3500 Grove City Rd Grove City OH 43123-2598 Ph: (614) 230-7005 | Evergreen Pathways Home Llc 3500 Grove City Rd Grove City OH 43123-2598 Ph: (614) 230-7005 |
| NPI Number | 1902615966 |
|---|---|
| Provider Enumeration Date | 01/04/2025 |
| Last Update Date | 01/04/2025 |
| Certification Date | 01/04/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902615966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TM1800X | Psychologist - Intellectual & Developmental Disabilities | (* (Not Available)) | Primary |
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