Organization
EVERGREEN HEALTHCARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH NICOLE BAILEY BS (EXECUTIVE DIRECTOR)
(724) 854-1839
Entity
Organization
Contact information
Practice address
417 MALLEABLE ST, SHARON, PA 16146-1936
(724) 347-7344
(724) 347-7345
Mailing address
417 MALLEABLE ST, SHARON, PA 16146-1936
(724) 347-7344
(724) 347-7345
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
78111
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019703400003
—
PA
05
—
2437643
—
OH
Enumeration date
07/19/2005
Last updated
08/22/2020
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