| Evolution Aba Llc | |
|
25 Olive St Bloomfield NJ 07003-3208 | |
| (855) 255-0800 | |
| (855) 255-0800 |
| Full Name | Evolution Aba Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 25 Olive St, Bloomfield, New Jersey |
| Authorized Official Name and Position | Heather Primus (OWNER) |
| Authorized Official Contact | 8552550800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolution Aba Llc 161 Main St Apt 208 West Orange NJ 07052-5636 Ph: (855) 255-0800 | Evolution Aba Llc 25 Olive St Bloomfield NJ 07003-3208 Ph: (855) 255-0800 |
| NPI Number | 1578245551 |
|---|---|
| Provider Enumeration Date | 08/01/2023 |
| Last Update Date | 08/01/2023 |
| Certification Date | 08/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578245551 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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