Evergreen Manor Iii, Inc

LBN: Evergreen Manor Iii, Inc
Evergreen Manor Iii, Inc is an health care organization with primary practice located at 8429 Idyllview Ave , Sparta WI 54656-3617. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as the primary health care specialty. Evergreen Manor Iii, Inc can be contacted via phone (608) 487-9067, or through Rosin, Larenda L via phone (608) 487-9067.

Contact Information

Primary practice address
8429 Idyllview Ave Sparta WI 54656-3617
Phone: (608) 487-9067
Fax: (608) 487-9067
Website:
Map and Directions
Authorized official contact:
Name: Rosin, Larenda L
Phone: (608) 487-9067

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X 0011807 Wisconsin

Profile Details

NPI number 1033447776
LBN Legal business name Evergreen Manor Iii, Inc
DBA Doing business as
Authorized official Rosin, Larenda L
Entity Organization
Organization subpart 1 No
Enumeration date Nov 18th, 2009
Last updated Nov 18th, 2009 - about 15 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.

Request for update

Popular Providers