Evergreen Elm, Inc.
NPI #1598936528 in Bradford, Pennsylvania
Provider Information
- NPI Number
- 1598936528
- Entity Type
- Organization
- Organization Name
- Evergreen Elm, Inc.
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Mar 18, 2008
- Last Updated
- Mar 18, 2008
Practice Location
- Address
- 71 MAIN STREET, SUITE 303
- City
- Bradford
- State
- Pennsylvania
- ZIP Code
- 16701-2029
- Phone
- (814) 362-6853
Authorized Official
- Name
- MR. GARRY I PUGRANT
- Title
- CEO
- Phone
- (814) 362-6853
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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