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Organization
EVERGREEN HEALTHCARE TREATMENT LLC
Active
Organization
EVERGREEN HEALTHCARE TREATMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATILDA BOACHIE (CEO)
(860) 967-2388
Entity
Organization
Contact information
Practice address
316 W PINNACLE RIDGE DR, SAN TAN VALLEY, AZ 85140-7047
(860) 967-2388
Mailing address
316 W PINNACLE RIDGE DR, SAN TAN VALLEY, AZ 85140-7047
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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