| NPI | 1356390918 |
|---|---|
| Doing Business As | EVERGREEN HEALTH SERVICES |
| Entity Type | Organization |
| Authorized Contact | JESSICA ANNE STACK A VP Of Revenue Cycle Mgmt 716-880-7399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 01711366) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: NY 01218524) |
| 207RI0200X Internal Medicine, Infectious Disease | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2022-11-29 |