Organization
EVOLVE BEHAVIORAL HEALTH, LLC
Active
Other names
Evolve Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
JESSI BLACKSTOCK TIDWELL CRNP (CO- OWNER)
(256) 394-0880
Entity
Organization
Contact information
Practice address
2904 MALL RD, FLORENCE, AL 35630-1641
(256) 767-3330
(949) 695-4340
Mailing address
2904 MALL RD, FLORENCE, AL 35630-1641
(256) 767-3330
(949) 695-4340
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/19/2024
Last updated
03/28/2025
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