Organization
EVOLVED, LLC
Active
Organization
EVOLVED, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS TODD SHEPARD JR. (CFO)
(910) 212-2261
Entity
Organization
Contact information
Practice address
4905 E 29TH ST, TUCSON, AZ 85711-6445
(910) 212-2261
(520) 704-6072
Mailing address
4905 E 29TH ST, TUCSON, AZ 85711-6445
(910) 212-2261
(520) 704-6072
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH-4071
AZ
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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