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Organization
DOMA OH LLC
Active
Organization
DOMA OH LLC
Active
Parent organization
EVOLVE CARE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVOLVE CARE LLC
Authorized official
BLAKE ELLIOTT (OWNER)
(612) 695-6041
Entity
Organization
Contact information
Practice address
1607 MOUNT CURVE AVE, MINNEAPOLIS, MN 55403-1015
(612) 695-6041
Mailing address
1607 MOUNT CURVE AVE, MINNEAPOLIS, MN 55403-1015
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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