Evergreen Hope Center LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

EVERGREEN HOPE CENTER LLC

Practice address

5701 Kentucky Ave N
Crystal, MN 55428-3370

Phone

(763) 923-8817

NPI assigned

Jun 6, 2025

Last updated

Jun 6, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Deo Shindano Deo

Title

Owner

Phone

(763) 406-6111

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749168000000",
    "number": "1417841065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 KENTUCKY AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 KENTUCKY AVE N",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283370",
            "telephone_number": "763-923-8817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN HOPE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-06",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A",
        "authorized_official_last_name": "SHINDANO DEO",
        "authorized_official_first_name": "DEO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-406-6111"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Crystal, MN
• Providers in Crystal, MN by specialty
• Adolescent and Children Mental Health Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2025; 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.