Evergreen Elm, Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

EVERGREEN ELM, INC.

Practice address

50 Main St
Bradford, PA 16701-6516

Phone

(814) 362-6853

Fax

(814) 362-1048

NPI assigned

Nov 29, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lori Trumbull

Title

Fiscal Director

Phone

(814) 362-6853

Specialties & licenses 1

Addresses

Tax ID family

Evergreen Elm Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Evergreen Elm, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Bradford, PA
  • NPI 1598936528
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1215470992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MAIN ST",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167016516",
            "telephone_number": "814-362-6853",
            "fax_number": "814-362-1048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MAIN ST",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "167016516",
            "telephone_number": "814-362-6853",
            "fax_number": "814-362-1048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN ELM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "TRUMBULL",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "FISCAL DIRECTOR",
        "authorized_official_telephone_number": "814-362-6853"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Elenchin
• Suzanne E English, RN
• Maria Fisher Enix, MSW,LCSW
• Kristy Erickson, RN
• Erie Vamc
• Evergreen Elm, Inc.
• Exigence of Bradford LLC
• Yahya Fadl, MD
• Family Eye Health Center P C
• Family Wellness Chiropractic Inc.

• In Home Supportive Care Agency in Bradford, PA
• Providers in Bradford, PA by specialty
• In Home Supportive Care Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.