National Provider Identifier Database

EVERGREEN RECOVERY LLC
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

EVERGREEN RECOVERY LLC
14 RANDALL ST
PORTLAND, ME04103
Phone: 781-469-6505
Fax:
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for EVERGREEN RECOVERY LLC

NPI Number 1053208710
Legal business name
LBN
EVERGREEN RECOVERY LLC
Authorized official AMANDA TERRANOVA - (PROGRAM MANAGER)
Entity Organization
Organization subpart No
Enumeration date 06/23/2025
Last updated 06/23/2025 - About 12 months 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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