Organization
EVERGREEN THERAPEUTIC TREATMENT CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE TUTTLE LPCC-S (CHIEF EXECUTIVE OF OPERATIONS)
(419) 733-3889
Entity
Organization
Contact information
Practice address
110 PARK CENTER DR, PARKERSBURG, WV 26101-1929
(419) 733-3889
Mailing address
322 46TH ST, VIENNA, WV 26105-1822
(419) 733-3889
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/25/2021
Last updated
03/25/2021
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