institution
Evergreen Manor,inc.
Mental Illness Community Based Residential Treatment Facility in Sparta, Wisconsin
NPI 1386972024

Evergreen Manor,inc. is a Mental Illness Community Based Residential Treatment Facility based in Sparta, WI. Evergreen Manor,inc. practices in Sparta, WI. The NPI Number for Evergreen Manor,inc. is 1386972024 and holds a License No. 0010512 (Wisconsin).

The current practice location address for Evergreen Manor,inc. is 8429 Idyllview Ave, Sparta, WI and can be reached out via phone at 608-487-9067 and via fax at 608-487-9067.

Location: 8429 Idyllview Ave, Sparta, WI, 54656-3617
institution
Provider Profile Details
NPI Number
1386972024
Provider Name
Evergreen Manor,inc.
Credential
Provider Entity Type
Organization
Address
8429 Idyllview Ave, Sparta, WI, 54656-3617
Phone Number
608-487-9067
Fax Number
608-487-9067
Provider Enumeration Date
11/18/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
8429 Idyllview Ave
City
State
Zip
54656-3617
Phone Number
608-487-9067
Fax Number
608-487-9067
person
Provider Business Mailing Address Details
Address
8429 Idyllview Ave
City
State
Zip
54656-3617
Phone Number
608-487-9067
Fax Number
608-487-9067
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
License No.
0010512 (Wisconsin)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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