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General NPI Number Information
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NPI Number | 1881385474
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Entity Type | Organization
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Legal Business Name | EVOLVE WITH INTEGRITY- CONSULTATION & BEHAVIORAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 3433 CLUB CIR
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City | LAKESHORE
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State | FL
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Zip | 33854-1230
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Country | US
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Telephone | 863-934-1152
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8574
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City | LAKESHORE
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State | FL
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Zip | 33854-8574
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Country | US
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Telephone | 863-934-1152
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHAREE LINO
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Credential | LMHC
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Telephone | 863-934-1152
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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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