| Evergreen Therapeutic Treatment Centers Llc | |
|
110 Park Center Dr Parkersburg WV 26101-1929 | |
| (419) 733-3889 | |
| Not Available |
| Full Name | Evergreen Therapeutic Treatment Centers Llc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 110 Park Center Dr, Parkersburg, West Virginia |
| Authorized Official Name and Position | Jamie Tuttle (CHIEF EXECUTIVE OF OPERATIONS) |
| Authorized Official Contact | 4197333889 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Therapeutic Treatment Centers Llc 322 46th St Vienna WV 26105-1822 Ph: (419) 733-3889 | Evergreen Therapeutic Treatment Centers Llc 110 Park Center Dr Parkersburg WV 26101-1929 Ph: (419) 733-3889 |
| NPI Number | 1720665987 |
|---|---|
| Provider Enumeration Date | 03/25/2021 |
| Last Update Date | 03/25/2021 |
| Certification Date | 03/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720665987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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