Provider Demographics
NPI:1508198847
Name:BEVANS & ASSOCIATES
Entity Type:Organization
Organization Name:BEVANS & ASSOCIATES
Other - Org Name:BRAZA HOME
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BOBBIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:612-250-0114
Mailing Address - Street 1:PO BOX 11356
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-0356
Mailing Address - Country:US
Mailing Address - Phone:612-522-5585
Mailing Address - Fax:612-522-8024
Practice Address - Street 1:1700 PENN AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-3054
Practice Address - Country:US
Practice Address - Phone:612-250-0114
Practice Address - Fax:612-522-8024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency