Provider Demographics
NPI:1639980881
Name:EVA LIFE GIVER INC.
Entity type:Organization
Organization Name:EVA LIFE GIVER INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CAC-AD, AS
Authorized Official - Phone:443-271-8046
Mailing Address - Street 1:5003 ARDMORE WAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-5004
Mailing Address - Country:US
Mailing Address - Phone:443-271-8046
Mailing Address - Fax:443-873-8959
Practice Address - Street 1:5620 MIDWOOD AVE
Practice Address - Street 2:APARTMENTS 1 & 2
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-4029
Practice Address - Country:US
Practice Address - Phone:443-873-8958
Practice Address - Fax:443-873-8959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities