| Evca, Llc | |
|
5355 Newberry St Wayne MI 48184-2305 | |
| (313) 207-3057 | |
| Not Available |
| Full Name | Evca, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5355 Newberry St, Wayne, Michigan |
| Authorized Official Name and Position | Evette N Carroll (OWNER/CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 3132073057 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evca, Llc 5355 Newberry St Wayne MI 48184-2305 Ph: (313) 207-3057 | Evca, Llc 5355 Newberry St Wayne MI 48184-2305 Ph: (313) 207-3057 |
| NPI Number | 1114689379 |
|---|---|
| Provider Enumeration Date | 10/05/2021 |
| Last Update Date | 10/05/2021 |
| Certification Date | 10/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114689379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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