Provider Demographics
NPI:1255527537
Name:EVANS ELECTRIFYING ENTERPRISES, INC.
Entity type:Organization
Organization Name:EVANS ELECTRIFYING ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BOBBYE
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, RA,
Authorized Official - Phone:702-655-4177
Mailing Address - Street 1:5528 GREEN WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-1646
Mailing Address - Country:US
Mailing Address - Phone:702-655-4177
Mailing Address - Fax:702-395-5247
Practice Address - Street 1:5528 GREEN WILLOW ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-1646
Practice Address - Country:US
Practice Address - Phone:702-655-4177
Practice Address - Fax:702-395-5247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health