| Evoke Changes Llc | |
|
753 Migration Rd Somers MT 59932-5993 | |
| (406) 823-0231 | |
| Not Available |
| Full Name | Evoke Changes Llc |
|---|---|
| Speciality | Psychologist |
| Location | 753 Migration Rd, Somers, Montana |
| Authorized Official Name and Position | Sean Bass Patrick (OWNER) |
| Authorized Official Contact | 4068230231 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evoke Changes Llc Po Box 1371 Kalispell MT 59903-1371 Ph: (406) 823-0231 | Evoke Changes Llc 753 Migration Rd Somers MT 59932-5993 Ph: (406) 823-0231 |
| NPI Number | 1316690852 |
|---|---|
| Provider Enumeration Date | 02/03/2022 |
| Last Update Date | 02/03/2022 |
| Certification Date | 02/01/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316690852 | NPI | - | NPPES |
| 523464 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |