Provider Demographics
NPI:1720416993
Name:EVOLVE HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:EVOLVE HEALTH CARE SERVICES LLC
Other - Org Name:JOYFUL TOO LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HILARY
Authorized Official - Middle Name:BRIGGS
Authorized Official - Last Name:PUZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-576-0691
Mailing Address - Street 1:614 ELDORADO ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NC
Mailing Address - Zip Code:27371-2628
Mailing Address - Country:US
Mailing Address - Phone:910-576-0691
Mailing Address - Fax:910-576-0691
Practice Address - Street 1:126 PINE ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-4587
Practice Address - Country:US
Practice Address - Phone:828-248-4369
Practice Address - Fax:828-248-4369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-081-099320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness