| Evergreen Supportive Care, Llc | |
|
7244 Henderson Ave Saint Louis MO 63121-5018 | |
| (314) 532-5583 | |
| (314) 200-2682 |
| Full Name | Evergreen Supportive Care, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 7244 Henderson Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | Bernadette Marie Brown (PRESIDENT) |
| Authorized Official Contact | 3145325583 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Supportive Care, Llc 7244 Henderson Ave Saint Louis MO 63121-5018 Ph: (314) 532-5583 | Evergreen Supportive Care, Llc 7244 Henderson Ave Saint Louis MO 63121-5018 Ph: (314) 532-5583 |
| NPI Number | 1639917313 |
|---|---|
| Provider Enumeration Date | 07/17/2024 |
| Last Update Date | 07/17/2024 |
| Certification Date | 07/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639917313 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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