Evergreen Therapy Center Llc

LBN: Evergreen Therapy Center Llc
Evergreen Therapy Center Llc is an health care organization with primary practice located at 2140 Norcor Ave Ste 103 , Coralville IA 52241-9736. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Adult Mental Health. Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Evergreen Therapy Center Llc can be contacted via phone (319) 853-8762, or through Drwal, Jason via phone (319) 853-8762.

Contact Information

Primary practice address
2140 Norcor Ave Ste 103 Coralville IA 52241-9736
Phone: (319) 853-8762
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Drwal, Jason PH. D.
Phone: (319) 853-8762

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Adult Mental Health 261QM0850X

Profile Details

NPI number 1043828825
LBN Legal business name Evergreen Therapy Center Llc
DBA Doing business as
Authorized official Drwal, Jason PH. D.
Entity Organization
Organization subpart 1 No
Enumeration date Jul 17th, 2020
Last updated Jul 17th, 2020 - about 5 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.

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