Evergreen Pines INC

NPI #1851721344 in Berlin, Wisconsin

Provider Information

NPI Number
1851721344
Entity Type
Organization
Organization Name
Evergreen Pines INC
Primary Specialty
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date
Nov 19, 2013
Last Updated
Nov 19, 2013

Practice Location

Address
343 E CUMBERLAND ST
City
Berlin
ZIP Code
54923-1206
Phone
(920) 290-3305

Authorized Official

Name
KERI M HAYWOOD
Title
PRESIDENT
Phone
(920) 229-3664

Specialties & Taxonomy Codes

Specialty
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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State of Wisconsin

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