Organization
EVERGREEN ELM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI TRUMBULL (FISCAL DIRECTOR)
(814) 362-6853
Entity
Organization
Contact information
Practice address
50 MAIN ST, BRADFORD, PA 16701-6516
(814) 362-6853
(814) 362-1048
Mailing address
50 MAIN ST, BRADFORD, PA 16701-6516
(814) 362-6853
(814) 362-1048
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
PA
Other
Enumeration date
11/29/2016
Last updated
07/21/2022
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