| Not Applicable | |
|
262 Crescent Ln Monroe VA 24574-3202 | |
| (434) 426-2244 | |
| Not Available |
| Full Name | Not Applicable |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 262 Crescent Ln, Monroe, Virginia |
| Authorized Official Name and Position | Cassandre Foster (LICENSED BEHAVIOR ANALYST) |
| Authorized Official Contact | 4344262244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Not Applicable 262 Crescent Ln Monroe VA 24574-3202 Ph: (434) 426-2244 | Not Applicable 262 Crescent Ln Monroe VA 24574-3202 Ph: (434) 426-2244 |
| NPI Number | 1689330375 |
|---|---|
| Provider Enumeration Date | 11/17/2021 |
| Last Update Date | 11/17/2021 |
| Certification Date | 11/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689330375 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Primary |
Evergreen Health LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 391 High Peak Rd, Monroe, VA 24574 Phone: 240-207-8382 Fax: 240-207-8382 |