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
—
—
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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