EVERGREEN HOME OF BERLIN, INC. – NPI #1063742526
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Mental Illness

EVERGREEN HOME OF BERLIN, INC. is a community based residential treatment facility located in BERLIN, WI. NPPES has assigned the NPI number 1063742526 to EVERGREEN HOME OF BERLIN, INC. on January 06, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EVERGREEN HOME OF BERLIN, INC. below.

NPI Profile for
EVERGREEN HOME OF BERLIN, INC.

NPI Number
1063742526
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EVERGREEN HOME OF BERLIN, INC.
Primary location
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
Phone: (608) 487-9067 Fax: (608) 487-9067
Organization Subpart
No
Authorized Official
LARENDA ROSIN
PRESIDENT
Phone: (608) 487-9067
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.