| NPI | 1043828825 |
|---|---|
| Former Legal Business Name | EVERGREEN THERAPY CENTER LLC |
| Entity Type | Organization |
| Authorized Contact | JASON MATTHEW DRWAL President 319-853-8762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2025-11-22 |