Organization
EVOLVE THERAPEUTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIDAH OTIENO (CO-OWNER)
(256) 468-2232
Entity
Organization
Contact information
Practice address
2307 W CONE BLVD STE 140, GREENSBORO, NC 27408-4063
(336) 772-4158
Mailing address
2307 W CONE BLVD STE 140, GREENSBORO, NC 27408-4063
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/07/2022
Last updated
04/07/2022
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