| Evolving Lives, Inc | |
|
24601 Packinghouse Rd Unit 2 Homestead FL 33032-3807 | |
| (786) 830-8171 | |
| Not Available |
| Full Name | Evolving Lives, Inc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 24601 Packinghouse Rd Unit 2, Homestead, Florida |
| Authorized Official Name and Position | Khristopher Lucin-caceres (PROGRAM DIRECTOR) |
| Authorized Official Contact | 7868308171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolving Lives, Inc 24601 Packinghouse Rd Unit 2 Homestead FL 33032-3807 Ph: () - | Evolving Lives, Inc 24601 Packinghouse Rd Unit 2 Homestead FL 33032-3807 Ph: (786) 830-8171 |
| NPI Number | 1205588423 |
|---|---|
| Provider Enumeration Date | 01/19/2022 |
| Last Update Date | 06/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205588423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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