NPI 1245028604
Evergreen Recovery LLC
Practice location
- Address
- 12 Randall St, Portland, ME 04103-5116
- Phone
- (781) 469-6505
- Mailing address
- 22 Redlon Rd, Portland, ME 04102-2218
Authorised official
- Name
- Amanda Terranova
- Title
- Program Coordinator
- Phone
- (617) 291-9224
Registered specialties
Substance Abuse Rehabilitation Facility
Primary
Registry record
- NPI
- 1245028604
- Entity type
- Organization
- NPI issued
- 28 Apr 2025
- Record last updated
- 28 Apr 2025
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.