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General NPI Number Information
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NPI Number | 1124278502
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Entity Type | Organization
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Legal Business Name | EVOLUTION HEALTHCARE SERVICES INC.
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 09/23/2008
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Provider Practice Location Address
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Address Line | 148 HAVENRIDGE
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City | ROCKWALL
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State | TX
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Zip | 75032-6269
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Country | US
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Telephone | 469-233-5525
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Fax | 972-635-5296
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Provider Business Mailing Address
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Address Line | 148 HAVENRIDGE
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City | ROCKWALL
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State | TX
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Zip | 75032-6269
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Country | US
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Telephone | 469-233-5525
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Fax | 972-635-5296
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Authorized Official
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Title or Position | ADMINISTRATOR/DON
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Name | MRS. ROSE B EDET
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Credential | RN
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Telephone | 469-233-5525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | PENDING
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PENDING
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License Number State | TX
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