National Provider Identifier Database

EVERGREEN COMMUNITY SUPPORTS LLC
Community/Behavioral Health

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.


Contact Information

EVERGREEN COMMUNITY SUPPORTS, LLC
316B STEAM SHOVEL ROAD
STANTON, KY40380
Phone: 859-644-2584
Fax:
Website:
Specialty Taxonomy Code
* Community/Behavioral Health 251S00000X

* Indicates primary specialty

NPI Profile & details for EVERGREEN COMMUNITY SUPPORTS, LLC

NPI Number 1154653897
Legal business name
LBN
EVERGREEN COMMUNITY SUPPORTS, LLC
Authorized official DEANA PACK - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 02/05/2010
Last updated 02/05/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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