# EVERGREEN HEALTHCARE CLINIC LIMITED LIABILITY COMPANY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659162402
- **Authorized official:** YVETTE LEDJO (CEO)
- **Authorized official phone:** (240) 644-5570

## Contact information

- **Practice address:** 300 N CHARLES ST STE D, BALTIMORE, MD 21201-4305
- **Practice address phone:** (240) 644-5570
- **Mailing address:** 13707 CROWNSGATE WAY, GERMANTOWN, MD 20874-4424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/13/2025
- **Last updated:** 07/07/2026