Organization
EVERGREEN YOUTH AND FAMILY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KARIE K BARRY (HR AND FACILITIES & SAFETY DIRECTOR)
(218) 308-9066
Entity
Organization
Contact information
Practice address
610 PATRIOT DR NW, BEMIDJI, MN 56601-4570
(218) 308-9006
(218) 751-8070
Mailing address
PO BOX 622, BEMIDJI, MN 56619-0622
(218) 308-9006
(218) 751-8070
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140171800
MHCP
MN
Enumeration date
09/14/2006
Last updated
10/17/2013
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