Organization
EVERGREEN THERAPY CENTER LLC
Active
Other names
Evergreen Therapy Center LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JASON MATTHEW DRWAL PH.D. (PRESIDENT)
(319) 853-8762
Entity
Organization
Contact information
Practice address
595 ASHLEY CT STE 5, NORTH LIBERTY, IA 52317-4758
(319) 853-8762
(319) 249-6875
Mailing address
595 ASHLEY CT STE 5, NORTH LIBERTY, IA 52317-4758
(319) 853-8762
(319) 249-6875
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
07/17/2020
Last updated
11/22/2025
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