Provider Demographics
NPI:1821698648
Name:EVOLUTION HOME CARE LLC
Entity Type:Organization
Organization Name:EVOLUTION HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:KALTENBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-326-5211
Mailing Address - Street 1:11581 NW 36TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-2609
Mailing Address - Country:US
Mailing Address - Phone:412-326-5211
Mailing Address - Fax:
Practice Address - Street 1:7401 WILES RD STE 214
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2038
Practice Address - Country:US
Practice Address - Phone:412-326-5211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care