OrganizationActive
Evergreen Manor III, Inc
NPI 1033447776 · Mental Illness Community Based Residential Treatment Facility · Sparta, WI
Provider details
- NPI number
- 1033447776
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Larenda Rosin, President(608) 487-9067
- License
- 0011807 (WI)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
8429 Idyllview Ave
Sparta, WI 54656-3617
Phone: (608) 487-9067
Fax: (608) 487-9067
Approximate (ZIP-level) locationGet directions
Mailing address
8429 Idyllview Ave
Sparta, WI 54656-3617
Registry dates
- Enumerated
- 2009-11-18
- Last updated
- 2009-11-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.