Organization
LET YOUR SOUL EVOLVE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLA RAJARAM (BILLING MANAGER)
(954) 272-6612
Entity
Organization
Contact information
Practice address
4723 W ATLANTIC AVE, SUITE A-21, DELRAY BEACH, FL 33445-3895
(561) 628-6651
Mailing address
4723 W ATLANTIC AVE, SUITE A-11, DELRAY BEACH, FL 33445-3895
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/17/2016
Last updated
11/17/2016
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