Organization
EVOLVE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JANNET TISDALE BLUE QMHP (CLINICAL DIRECTOR)
(336) 926-6463
Entity
Organization
Contact information
Practice address
897 PETERS CREEK PKWY STE 101, WINSTON SALEM, NC 27103-3858
(336) 725-9135
(336) 725-9139
Mailing address
897 PETERS CREEK PKWY STE 101, WINSTON SALEM, NC 27103-3858
(336) 725-9135
(336) 725-9139
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NC
Other
Enumeration date
12/18/2008
Last updated
12/18/2008
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