| Evolutional Group Living Llc | |
|
296 Highgate Ave Buffalo NY 14215-1026 | |
| (716) 598-0554 | |
| Not Available |
| Full Name | Evolutional Group Living Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 296 Highgate Ave, Buffalo, New York |
| Authorized Official Name and Position | Aaron Adams (ADMINISTRATOR) |
| Authorized Official Contact | 6672701122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolutional Group Living Llc 19 Vanderbilt Dr Aiken SC 29803-6280 Ph: () - | Evolutional Group Living Llc 296 Highgate Ave Buffalo NY 14215-1026 Ph: (716) 598-0554 |
| NPI Number | 1891523270 |
|---|---|
| Provider Enumeration Date | 07/25/2024 |
| Last Update Date | 07/25/2024 |
| Certification Date | 07/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891523270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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