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General NPI Number Information
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NPI Number | 1629302450
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Entity Type | Organization
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Legal Business Name | EVE'S COMMUNITY SERVICES LLC
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Dates
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Enumeration Date | 09/27/2009
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Last Update Date | 09/27/2009
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Provider Practice Location Address
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Address Line | 2200 E MARKET ST SUITE B
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City | GREENSBORO
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State | NC
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Zip | 27401-6443
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Country | US
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Telephone | 336-272-3483
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Fax | 336-272-3484
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Provider Business Mailing Address
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Address Line | 14916 NORTHGREEN DR
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City | HUNTERSVILLE
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State | NC
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Zip | 28078-2628
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Country | US
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Telephone | 704-875-6454
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Fax | 704-875-6445
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | EVA L CLARK
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Credential |
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Telephone | 704-875-6454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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