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Organization

EVOLVENCHANGE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LETISHA HOGANS APN (PSYCHIATRIC MENTAL HEALTH NURSE PRA)
(609) 422-0923
Entity
Organization

Contact information

Practice address
1451 CHEWS LANDING RD STE 207, LAUREL SPRINGS, NJ 08021-2766
(856) 341-2208
Mailing address
1451 CHEWS LANDING RD STE 207, LAUREL SPRINGS, NJ 08021-2766
(856) 341-2208

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary

Other

Enumeration date
07/02/2021
Last updated
07/02/2021
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