OrganizationEvergreen Counseling, Inc.Community/Behavioral HealthAgenciesPractice Address5300 W Sahara Ave, Suite 104, Las Vegas, NV 89146-0353(702) 248-6290PECOS EnrollmentBased on the most recent information from CMS, provider Evergreen Counseling, Inc. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1578789020Provider TypeOrganizationFull NameEvergreen Counseling, Inc.SubpartNoEnumeration Date4/17/2007Last Updated8/22/2020Contact InformationPractice LocationPractice Address5300 W Sahara Ave, Suite 104, Las Vegas, NV 89146-0353Phone(702) 248-6290Fax(702) 248-4720Mailing LocationMailing Address5300 W Sahara Ave, Suite 104, Las Vegas, NV 89146-0353Phone(702) 248-6290Fax(702) 248-4720Authorized OfficialNameWagner, Thomas C (Clinical Director)Phone(702) 248-6290Provider TaxonomiesCodeDescriptionLicenseCode251S00000XPrimaryDescriptionCommunity/Behavioral HealthAgenciesLicense01761-CNevada