MEDICARE: EVERGREEN SUPPORTIVE CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1639917313
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERGREEN SUPPORTIVE CARE, LLC

Provider Business Mailing Address
First Line	:	7244 HENDERSON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-5018
Country	:	US
Telephone Number	:	314-532-5583
Fax Number	:	314-200-2682

Provider Business Practice Location Address
First Line	:	7244 HENDERSON AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63121-5018
Country	:	US
Telephone Number	:	314-532-5583
Fax Number	:	314-200-2682

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. BERNADETTE MARIE BROWN
Credential	:
Telephone Number	:	314-532-5583

Provider Enumeration Date	:	07/17/2024
Last Update Date	:	07/17/2024

Similar Medicare Providers

1942735998 — HEAVENLY HANDS IN HOME CARE, INC
Practice Location Address:

5018 LOTUS AVE
SAINT LOUIS, MO
63113-1126

Practice Phone: 314-809-0326
Practice Fax: 314-769-9278

1275570558 — MICHAEL J DETKE M.D.
Practice Location Address:

5018 SAINT CHARLES PL
CARMEL, IN
46033-5940

Practice Phone: 317-902-2002
Practice Fax:

1679733752 — ALL ACROSS AMERICA AMBULANCE SERVICE
Practice Location Address:

5018 SAINT KITTS
DICKINSON, TX
77539-6183

Practice Phone: 281-573-8527
Practice Fax: 281-404-5631

1699087593 — ABOUT YOU HOME HEALTH AND MEDICAL SUPPLIES, INC.
Practice Location Address:

201 SW PORT SAINT LUCIE BLVD , SUITE #206
PORT SAINT LUCIE, FL
34984-5018

Practice Phone: 772-236-7898
Practice Fax: 888-792-6585

1316800584 — DIVINE CARE TRANSIT LLC
Practice Location Address:

3714 NELSON DR
SAINT LOUIS, MO
63121-3410

Practice Phone: 557-219-4824
Practice Fax:

1154285302 — ACORP ADULT DAY PROGRAM CORP
Practice Location Address:

6936 GREENWAY AVE
SAINT LOUIS, MO
63121-5129

Practice Phone: 314-650-9615
Practice Fax:

Directions to “EVERGREEN SUPPORTIVE CARE, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.