Provider Demographics
NPI:1639641848
Name:EVOLUTION RECOVERY ASHEVILLE, LLC
Entity Type:Organization
Organization Name:EVOLUTION RECOVERY ASHEVILLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:NUTT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCAS
Authorized Official - Phone:828-577-2598
Mailing Address - Street 1:932 HENDERSONVILLE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1733
Mailing Address - Country:US
Mailing Address - Phone:828-577-2598
Mailing Address - Fax:
Practice Address - Street 1:932 HENDERSONVILLE RD STE 105
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1733
Practice Address - Country:US
Practice Address - Phone:828-577-2598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health