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Evergreen Elm, Inc.
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Bradford, Pennsylvania
NPI 1598936528

Evergreen Elm, Inc. is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Bradford, PA. Evergreen Elm, Inc. practices in Bradford, PA. The NPI Number for Evergreen Elm, Inc. is 1598936528 and holds a License No. 426070 (Pennsylvania).

The current practice location address for Evergreen Elm, Inc. is 71 Main Street, Suite 303, Bradford, PA and can be reached out via phone at 814-362-6853 and via fax at 814-362-1048.

Location: 71 Main Street, Suite 303, Bradford, PA, 16701-2029
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1598936528
Provider Name
Evergreen Elm, Inc.
Credential
Provider Entity Type
Organization
Address
71 Main Street, Suite 303, Bradford, PA, 16701-2029
Phone Number
814-362-6853
Fax Number
814-362-1048
Provider Enumeration Date
03/18/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
71 Main Street, Suite 303
City
Bradford
State
Pennsylvania
Zip
16701-2029
Phone Number
814-362-6853
Fax Number
814-362-1048
person
Provider Business Mailing Address Details
Address
71 Main Street, Suite 303
City
Bradford
State
Pennsylvania
Zip
16701-2029
Phone Number
814-362-6853
Fax Number
814-362-1048
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
426070 (Pennsylvania)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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