Organization
EVERGREEN RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA TERRANOVA (PROGRAM COORDINATOR)
(617) 291-9224
Entity
Organization
Contact information
Practice address
12 RANDALL ST, PORTLAND, ME 04103-5116
(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
04/28/2025
Last updated
04/28/2025
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