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EVERGREEN MANOR III, INC
NPI 1033447776
Community Based Residential Treatment Facility, Mental Illness in Sparta, WI

Active since November 18, 2009
8429 IDYLLVIEW AVE, SPARTA, WI 54656(608) 487-9067(608) 487-9067 Get Directions Write a Review

NPPES record last updated: November 18, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Evergreen Manor Iii, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN MANOR III, INC (NPI 1033447776) is a healthcare organization registered as a community based residential treatment facility, mental illness in Sparta, Wisconsin and active in the NPI registry since November 2009. The organization lists Larenda L Rosin, President, as its authorized official.

NPPES Registry Identity

NPI1033447776
Entity TypeOrganization
Primary Taxonomy320800000X
Legal Business NameEVERGREEN MANOR III, INC
Location Address8429 IDYLLVIEW AVESparta, WI 54656-3617
Mailing Address8429 Idyllview AveSparta, WI 54656-3617 · (608) 487-9067 · Fax (608) 487-9067
Phone(608) 487-9067
Fax(608) 487-9067
Organization SubpartNo
Authorized OfficialLarenda L RosinPresident · (608) 487-9067
Enumeration DateNovember 18, 2009
✔ NPI 1033447776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Mental IllnessResidential Treatment Facilities
Taxonomy Code320800000X
License✔ Licensed in WI · 0011807
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
8429 IDYLLVIEW AVE, Sparta, WI 54656
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EVERGREEN MANOR,INC.
Community Based Residential Treatment Facility, Mental Illness
8429 IDYLLVIEW AVE
SPARTA, WI 54656
Monroe County (608) 487-9067
EVERGREEN MANOR II
Community Based Residential Treatment Facility, Mental Illness
8429 IDYLLVIEW AVE
SPARTA, WI 54656
Monroe County (608) 487-9067

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evergreen Manor III, Inc's NPI number?

The NPI number for Evergreen Manor III, Inc is 1033447776. It was assigned to this organization in the NPPES registry on November 18, 2009.

Where is Evergreen Manor III, Inc located?

Evergreen Manor III, Inc is located at 8429 Idyllview Ave, Sparta, WI 54656. The listed phone number is (608) 487-9067.

What is Evergreen Manor III, Inc's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.

When was this NPI record last updated?

The NPPES record for Evergreen Manor III, Inc was last updated on November 18, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.