Evergreen Southwest Behavioral Health Services LLC

Primary specialty

Psychiatric HospitalTaxonomy code 283Q00000X

Legal business name

EVERGREEN SOUTHWEST BEHAVIORAL HEALTH SERVICES LLC

Practice address

5500 Verulam Ave
Cincinnati, OH 45213-2418

Phone

(513) 531-6444

Fax

(513) 531-9444

NPI assigned

May 21, 2009

Organization subpart

Yes

Parent organization

EVERGREEN SOUTHWEST BEHAVIORALHEALTH SERVICES LLCAs reported in NPPES

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

Authorized official

Name

Ms. Elizabeth Darlene Mitchell, M.H.A.

Title

Coo/Administrator

Phone

(513) 531-6444

Specialties & licenses 1

Addresses

Other names 1

• Bridgewell Hospital of Cincinnati Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 364046

Legal name

BRIDGEWELL HOSPITAL OF CINCINNATI

Certification status

Terminated Involuntary: failure to meet health/safety requirements, Oct 3, 2014

Provider type (POS)

Hospital – Psychiatric

Participating since

Apr 27, 2012

Last certification

Sep 25, 2014

Beds

24

Ownership / control type

Private (for profit)

Facility address

5500 Verulam Street
Cincinnati, OH 45213

Part of

Evergreen Southwest Behavioral Health Services LLC

Locations

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

{
    "created_epoch": "1242864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273536000000",
    "number": "1497980338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MIRANOVA PL",
            "address_2": "SUITE 310",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432155078",
            "telephone_number": "614-334-6196",
            "fax_number": "614-461-7168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 VERULAM AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452132418",
            "telephone_number": "513-531-6444",
            "fax_number": "513-531-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN SOUTHWEST BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERGREEN SOUTHWEST BEHAVIORALHEALTH SERVICES LLC",
        "enumeration_date": "2009-05-21",
        "last_updated": "2010-05-11",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "DARLENE",
        "authorized_official_title_or_position": "COO/ADMINISTRATOR",
        "authorized_official_telephone_number": "513-531-6444",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.H.A."
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgewell Hospital of Cincinnati",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dayton F Everett
• Jessica N Everett, M.S.
• Patrice L Everett
• Ricahrd Everett, RN
• Evergreen Home Care
• Tyler Jay Everhardt, PHARMD
• Joseph Lynn Everhart, DC
• Michael R. Everhart, CRNA
• Scott L Everhart, PA-C
• Everlight Healthcare

• Psychiatric Hospital in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Psychiatric Hospital in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.