Provider Demographics
NPI:1841941119
Name:EVOLVE HEALTH PARTNERS
Entity type:Organization
Organization Name:EVOLVE HEALTH PARTNERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:CSC-AD
Authorized Official - Phone:301-538-4114
Mailing Address - Street 1:2528 MOUNTAIN RD STE 204
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-7204
Mailing Address - Country:US
Mailing Address - Phone:443-548-3733
Mailing Address - Fax:
Practice Address - Street 1:2528 MOUNTAIN RD STE 104
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:MD
Practice Address - Zip Code:21122-7202
Practice Address - Country:US
Practice Address - Phone:443-548-3733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD661014500Medicaid