| Evolvenchange, Llc | |
|
1451 Chews Landing Rd Ste 207 Laurel Springs NJ 08021-2766 | |
| (856) 341-2208 | |
| Not Available |
| Full Name | Evolvenchange, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1451 Chews Landing Rd Ste 207, Laurel Springs, New Jersey |
| Authorized Official Name and Position | Letisha Hogans (PSYCHIATRIC MENTAL HEALTH NURSE PRA) |
| Authorized Official Contact | 6094220923 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolvenchange, Llc 1451 Chews Landing Rd Ste 207 Laurel Springs NJ 08021-2766 Ph: (856) 341-2208 | Evolvenchange, Llc 1451 Chews Landing Rd Ste 207 Laurel Springs NJ 08021-2766 Ph: (856) 341-2208 |
| NPI Number | 1013588862 |
|---|---|
| Provider Enumeration Date | 07/02/2021 |
| Last Update Date | 07/02/2021 |
| Certification Date | 07/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013588862 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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