| Evergreen Therapy Services | |
|
1070 W Horizon Ridge Pkwy Ste 210 Henderson NV 89012-6020 | |
| (406) 396-5168 | |
| (702) 405-0924 |
| Full Name | Evergreen Therapy Services |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1070 W Horizon Ridge Pkwy Ste 210, Henderson, Nevada |
| Authorized Official Name and Position | Jakob Mauer (OWNER/THERAPIST) |
| Authorized Official Contact | 7028591097 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Therapy Services 6909 Graceful Cloud Ave Henderson NV 89011-4980 Ph: () - | Evergreen Therapy Services 1070 W Horizon Ridge Pkwy Ste 210 Henderson NV 89012-6020 Ph: (406) 396-5168 |
| NPI Number | 1841046364 |
|---|---|
| Provider Enumeration Date | 04/25/2024 |
| Last Update Date | 04/25/2024 |
| Certification Date | 04/25/2024 |
| Medicare PECOS PAC ID | 1153867056 |
|---|---|
| Medicare Enrollment ID | O20240727000690 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841046364 | NPI | - | NPPES |
| Provider Name | Jakob Mauer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467027649 PECOS PAC ID: 0345641387 Enrollment ID: I20210628001980 |
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