EVERGREEN SUPPORTIVE CARE LLC NPI 1639917313

NPI Information

  • NPI: 1639917313
  • Provider Name: EVERGREEN SUPPORTIVE CARE, LLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 7244 HENDERSON AVE
    SAINT LOUIS, MO
    ZIP 63121
  • Phone: (314) 532-5583

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NPI Details

EVERGREEN SUPPORTIVE CARE, LLC is a mental health (including community mental health center) clinic center in Saint Louis, MO. EVERGREEN SUPPORTIVE CARE, LLC NPI is 1639917313. The provider is registered as an organization entity type.

The provider's business location address is:

7244 HENDERSON AVE
SAINT LOUIS, MO
ZIP 63121-018
Phone: (314) 532-5583
Fax: (314) 200-2682

The provider's authorized official is Bernadette Marie Brown .
The authorized official title is President and has the following contact phone number (314) 532-5583.

The enumeration date for this NPI number is 7/17/2024 and was last updated on 7/17/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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