NPI 1063742526

Evergreen Home of Berlin, INC.

Organisation Mental Illness Community Based Residential Treatment Facility Berlin, WI

Practice location

Address: 508 E Marquette St, Berlin, WI 54923-9404
Phone: (920) 361-3231
Fax: (920) 361-3231
Mailing address: 8429 Idyllview Ave, Sparta, WI 54656-3617

Authorised official

Name: Larenda L Rosin
Title: President
Phone: (608) 487-9067

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X

Other Community Based Residential Treatment Facility, Mental Illness providers in Wisconsin →

Registry record

NPI: 1063742526
Entity type: Organization
NPI issued: 6 Jan 2010
Record last updated: 6 Jan 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.