Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Evergreen Manor, Inc

Organization Mental Illness Community Based Residential Treatment Facility · NPI 1386972024

Evergreen Manor, Inc is a Mental Illness Community Based Residential Treatment Facility in Sparta, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2009.

Licensed in
WI
In the registry since
2009
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8429 Idyllview Ave
Sparta, WI 54656-3617
Phone: (608) 487-9067
Fax: (608) 487-9067
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Illness Community Based Residential Treatment Facility (primary) Taxonomy 320800000X · Licence 0010512 (WI)

Record details

NPI number1386972024
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Larenda Rosin — President · (608) 487-9067
NPI enumeratedNovember 18, 2009
Last updated in NPPESNovember 18, 2009
Mailing address8429 Idyllview Ave, Sparta, WI 54656-3617

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