Provider Demographics
NPI:1609198795
Name:EVOLUTION SERVICES INC.
Entity Type:Organization
Organization Name:EVOLUTION SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-240-3732
Mailing Address - Street 1:725 W ALDER ST
Mailing Address - Street 2:SUITE 20
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4036
Mailing Address - Country:US
Mailing Address - Phone:406-240-3732
Mailing Address - Fax:406-728-4009
Practice Address - Street 1:725 W ALDER ST
Practice Address - Street 2:SUITE 20
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4036
Practice Address - Country:US
Practice Address - Phone:406-240-3732
Practice Address - Fax:406-728-4009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit