Organization
EVERGREEN RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS AMANDA TERRANOVA (PROGRAM MANAGER)
(617) 291-9224
Entity
Organization
Contact information
Practice address
14 RANDALL ST, PORTLAND, ME 04103
(781) 469-6505
Mailing address
22 REDLON RD, PORTLAND, ME 04102-2218
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/23/2025
Last updated
06/23/2025
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