| Evolution Psychiatric And Mental Health Services, Llc | |
|
1204 Nw 69th Ter Ste B Gainesville FL 32605-3139 | |
| (352) 575-3600 | |
| (352) 641-9592 |
| Full Name | Evolution Psychiatric And Mental Health Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1204 Nw 69th Ter Ste B, Gainesville, Florida |
| Authorized Official Name and Position | Aijay Richards (PMHNP) |
| Authorized Official Contact | 3525753600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evolution Psychiatric And Mental Health Services, Llc 1204 Nw 69th Ter Ste B Gainesville FL 32605-3139 Ph: (352) 575-3600 | Evolution Psychiatric And Mental Health Services, Llc 1204 Nw 69th Ter Ste B Gainesville FL 32605-3139 Ph: (352) 575-3600 |
| NPI Number | 1972262699 |
|---|---|
| Provider Enumeration Date | 12/09/2021 |
| Last Update Date | 01/28/2024 |
| Certification Date | 01/28/2024 |
| Medicare PECOS PAC ID | 9638559990 |
|---|---|
| Medicare Enrollment ID | O20220704000164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972262699 | NPI | - | NPPES |
| Provider Name | Aijay A Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538392931 PECOS PAC ID: 1850729088 Enrollment ID: I20200325002963 |
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