Evergreen Healing Center, Llc
LBN: Evergreen Healing Center, Llc
Evergreen Healing Center, Llc is an health care organization with primary practice located at 224 State St , Bangor ME 04401-3434. The organization recently has 3 registered licenses in different health care specialties including Other Service Providers / Naturopath, Ambulatory Health Care Facilities / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is the primary health care specialty.
Evergreen Healing Center, Llc can be contacted via phone (207) 512-0584, or through Bridgman, Laura Tremaine via phone (207) 512-0584.
Contact Information
Primary practice address
224 State St
Bangor ME 04401-3434
Phone: (207) 512-0584
Fax: (207) 990-6604
Website:
Authorized official contact:
Name: Bridgman, Laura Tremaine Family Nurse Practitioner (FNP)
Phone: (207) 512-0584
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Naturopath | 175F00000X | ||
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | AP081246 | Maine |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X |
Profile Details
| NPI number | 1578892147 |
|---|---|
| LBN Legal business name | Evergreen Healing Center, Llc |
| DBA Doing business as | |
| Authorized official | Bridgman, Laura Tremaine Family Nurse Practitioner (FNP) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 10th, 2009 |
| Last updated | Oct 26th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578892147 | NPPES |
| Maine | MEDICAID | 246520000 |
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