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General NPI Number Information
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NPI Number | 1891463675
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Entity Type | Organization
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Legal Business Name | EVANA HEALTH SERVICES
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Dates
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Enumeration Date | 09/05/2021
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Last Update Date | 09/05/2021
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Provider Practice Location Address
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Address Line | 13000 HARBOR CENTER DR STE 102G
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City | WOODBRIDGE
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State | VA
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Zip | 22192-2847
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Country | US
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Telephone | 571-292-6272
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Fax |
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Provider Business Mailing Address
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Address Line | 12526 HOMESTEAD DR
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City | NOKESVILLE
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State | VA
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Zip | 20181-1702
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Country | US
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Telephone | 571-292-6272
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | EVELYN NUWORDU
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Credential | DNP
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Telephone | 571-292-6272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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