Provider Demographics
NPI:1881345908
Name:EVALS BY ECK LIMITED LIABILITY COMPANY EVALSBYECK
Entity type:Organization
Organization Name:EVALS BY ECK LIMITED LIABILITY COMPANY EVALSBYECK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:ECKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:CSW, LADC
Authorized Official - Phone:308-225-4780
Mailing Address - Street 1:3321 AVENUE I # 1603
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4586
Mailing Address - Country:US
Mailing Address - Phone:308-225-4780
Mailing Address - Fax:308-217-4277
Practice Address - Street 1:3321 AVENUE I STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4586
Practice Address - Country:US
Practice Address - Phone:308-225-4780
Practice Address - Fax:308-217-4277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty