Organization
EVCA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EVETTE N CARROLL LMSW (OWNER/CHIEF EXECUTIVE OFFICER)
(313) 207-3057
Entity
Organization
Contact information
Practice address
5355 NEWBERRY ST, WAYNE, MI 48184-2305
(313) 207-3057
Mailing address
5355 NEWBERRY ST, WAYNE, MI 48184-2305
(313) 207-3057
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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