| The Mom Evolution | |
|
45 Nw Greeley Ave Bend OR 97703-2943 | |
| (877) 831-1535 | |
| Not Available |
| Full Name | The Mom Evolution |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 45 Nw Greeley Ave, Bend, Oregon |
| Authorized Official Name and Position | Adeline Holter (THERAPIST AND OWNER) |
| Authorized Official Contact | 8778311535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Mom Evolution 45 Nw Greeley Ave Bend OR 97703-2943 Ph: (877) 831-1535 | The Mom Evolution 45 Nw Greeley Ave Bend OR 97703-2943 Ph: (877) 831-1535 |
| NPI Number | 1144815135 |
|---|---|
| Provider Enumeration Date | 03/02/2021 |
| Last Update Date | 03/02/2021 |
| Certification Date | 03/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144815135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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