Provider Demographics
NPI:1902379910
Name:EVOLVE HEALTHCARE SERVICES INC.
Entity Type:Organization
Organization Name:EVOLVE HEALTHCARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FOLASHADE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-352-0038
Mailing Address - Street 1:3115 GEORGIA AVE NW STE 1B
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2901
Mailing Address - Country:US
Mailing Address - Phone:202-352-0038
Mailing Address - Fax:
Practice Address - Street 1:3115 GEORGIA AVE NW STE 1B
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2901
Practice Address - Country:US
Practice Address - Phone:202-352-0038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC400319000677OtherBUSINESS LICENCE