The Evolution Group Inc. | |
218 Broadway Blvd Se Albuquerque NM 87102-3425 | |
(505) 242-6988 | |
(505) 242-6972 |
Full Name | The Evolution Group Inc. |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 218 Broadway Blvd Se, Albuquerque, New Mexico |
Authorized Official Name and Position | Daniel Blackwood (DIRECTOR) |
Authorized Official Contact | 5052426988 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
The Evolution Group Inc. 218 Broadway Blvd Se Albuquerque NM 87102-3425 Ph: (505) 242-6988 | The Evolution Group Inc. 218 Broadway Blvd Se Albuquerque NM 87102-3425 Ph: (505) 242-6988 |
NPI Number | 1285801191 |
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Provider Enumeration Date | 05/09/2008 |
Last Update Date | 12/10/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1285801191 | NPI | - | NPPES |
87423251 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
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