Organization
EVERGREEN RESIDENTIAL SERVICES LLC
Active
Organization
EVERGREEN RESIDENTIAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ABOSEDE DINA (OWNER)
(240) 601-9977
Entity
Organization
Contact information
Practice address
6405 DORSET DR, ALEXANDRIA, VA 22310-3015
(240) 601-9977
Mailing address
6405 DORSET DR, ALEXANDRIA, VA 22310-3015
(240) 601-9977
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
06/26/2026
Last updated
06/26/2026
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