EVERGREEN THERAPY CENTER LLC (NPI# 1043828825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043828825 |
| Entity Type | Organization |
| Organization Name | EVERGREEN THERAPY CENTER LLC |
| Practice Address |
2140 Norcor Ave Ste 103 Coralville IA 52241-9736 |
| Mailing Address |
144 Lockmoor Cir North Liberty IA 52317-8042 |
| Practice Telephone | 3198538762 |
| Mailing Telephone | 3198538762 |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-07-17 |
| Authorized Official Name | JASON DRWAL (OWNER) |
| Authorized Official Telephone | 3198538762 |
| Authorized Official Credential | PH. D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Evergreen Therapy Center LLC | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | EVERGREEN THERAPY CENTER LLC | 2140 Norcor Ave Ste 103, Coralville, IA 52241 |
| Street Address |
2140 NORCOR AVE STE 103 |
| City | CORALVILLE |
| State | IA |
| Zip Code | 52241-9736 |
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| 1215575394 | Eastern Iowa Rehabilitation Hospital, LLC | Rehabilitation Hospital | 2801 Heartland Drive, Coralville, IA 52241 | 2019-12-19 |
| 1851938690 | Matthew Easley | Speech-Language Pathologist | 2854 Coral Court, Ste 1, On With Life Outpatient Neuro Rehabilitation, Coralville, IA 52241 | 2019-11-27 |
| 1245892629 | On With Life, Inc | Clinic/Center | 2854 Coral Court, Suite 1, Coralville, IA 52241 | 2019-07-05 |
| 1376024869 | Hy Vee Inc | Pharmacy | 3285 Crosspark Road, Coralville, IA 52241 | 2018-08-23 |
| 1861996191 | Roggy Vision Center, Pllc | Optometrist | 708 5th St Ste 1, Coralville, IA 52241 | 2018-03-21 |
| 1013446467 | Monica Basile | Midwife | 501 12th Ave, St 102, Coralville, IA 52241 | 2017-06-08 |
| 1568893121 | Mohamed Karim | Chiropractor | 1801 Brown Deer Trail, Coralville, IA 52241 | 2013-12-09 |
| 1689011405 | Nicole Ann Wagaman | Family Medicine | 2801 Heartland Dr., Coralville, IA 52241 | 2013-06-03 |
| Find all providers in zip 52241 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1285243337 | Ames Creative Healing Counseling | Clinic/Center | 2135 N Dakota Ave, Ames, IA 50014-9016 | 2020-07-24 |
| 1487289252 | Compass Counseling Services, LLC | Clinic/Center | 305 Tara Way, Lawton, IA 51030-1026 | 2020-03-11 |
| 1457986457 | Compassionate Counseling LLC | Clinic/Center | 402 N B St Ste 104, Fairfield, IA 52556-2971 | 2020-03-10 |
| 1053945576 | North Central Iowa Mental Health Center Inc | Clinic/Center | 2633 Anchorage Rd Ne, Solon, IA 52333-9556 | 2020-02-24 |
| 1811533649 | Community Health Centers of Southern Iowa, Inc. | Clinic/Center | 219 W Washington St Ste 300, Osceola, IA 50213-1249 | 2019-11-27 |
| 1568007805 | Community Health Centers of Southern Iowa, Inc. | Clinic/Center | 219 W Washington St Ste 200, Osceola, IA 50213-1249 | 2019-11-11 |
| 1548805021 | Central Iowa Trauma and Recovery Center | Clinic/Center | 301 E Court Ave Ste 105, Des Moines, IA 50309-2004 | 2019-11-08 |
| 1750938825 | Paradocs Psychological Services | Clinic/Center | 1400 Walnut St #110, Onyx Business, Des Moines, IA 50309 | 2019-08-22 |
| Find all providers with the same taxonomy | ||||
| City | CORALVILLE |
| Zip Code | 52241 |
Please comment or provide details below to improve the information on EVERGREEN THERAPY CENTER LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.