Evergreen Supportive Care, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EVERGREEN SUPPORTIVE CARE, LLC

Doing business as

Evergreen Supportive Care

Practice address

7244 Henderson Ave
Saint Louis, MO 63121-5018

Phone

(314) 532-5583

Fax

(314) 200-2682

NPI assigned

Jul 17, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Bernadette Marie Brown

Title

President

Phone

(314) 532-5583

Specialties & licenses 1

Addresses

Other names 1

• Evergreen Supportive Care Doing business as

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

{
    "created_epoch": "1721174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1639917313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7244 HENDERSON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631215018",
            "telephone_number": "314-532-5583",
            "fax_number": "314-200-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7244 HENDERSON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631215018",
            "telephone_number": "314-532-5583",
            "fax_number": "314-200-2682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN SUPPORTIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "BERNADETTE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-532-5583",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Supportive Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erin Nicole Everett, CNM
• Eshon Everett, CVD
• Quentin Everett Jr., OTA
• Evergreen Adult Day Center, LLC
• Evergreen Home Care LLC
• Everlasting Care, LLC
• Catherine Marie Evers Smith, MD
• Alex S Evers, MD
• Amy Evers, M.D.
• Carol Jane Evers, M.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.