Organization
EVERGREEN THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAKOB MAUER DSW, LCSW (OWNER/THERAPIST)
(702) 859-1097
Entity
Organization
Contact information
Practice address
1070 W HORIZON RIDGE PKWY STE 210, HENDERSON, NV 89012-6020
(406) 396-5168
(702) 405-0924
Mailing address
6909 GRACEFUL CLOUD AVE, HENDERSON, NV 89011-4980
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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