Evergreen Healthcare Treatment LLC

Primary specialty

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

Legal business name

EVERGREEN HEALTHCARE TREATMENT LLC

Practice address

316 W Pinnacle Ridge Dr
San Tan Valley, AZ 85140-7047

Phone

(860) 967-2388

NPI assigned

Aug 24, 2023

Last updated

Aug 24, 2023By 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

Matilda BoachieNPI 1306571468

Title

Ceo

Phone

(860) 967-2388

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matilda Boachie, PMHNP

  • Psychiatry Physician
  • San Tan Valley, AZ
  • NPI 1306571468
  Authorized official Same address or phone

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1669256079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 W PINNACLE RIDGE DR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W PINNACLE RIDGE DR",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407047",
            "telephone_number": "860-967-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN HEALTHCARE TREATMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "BOACHIE",
        "authorized_official_first_name": "MATILDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "860-967-2388"
    },
    "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": []
}

• Enticare PC
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• Kaitlyn Ann Evans
• Nathaniel Spencer Evans, CNC
• Lorena Everhart, PT
• Experience Physical Therapy LLC
• Chidozie C Eze, FNP
• Lorraine D Fajardo, FNP-BC
• Anyssa Falcon, SLPA

• Mental Health Clinic/Center (Including Community Mental Health Center) in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.