Evolution Mind, Llc

LBN: Evolution Mind, Llc
Evolution Mind, Llc is an health care organization with primary practice located at 2130 Millburn Ave Ste D2 , Maplewood NJ 07040-3749. The organization recently has only one registered license in Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), which is considered as the primary health care specialty. Evolution Mind, Llc can be contacted via phone (973) 801-1801, or through Baskerville-Williams, Kira via phone (973) 801-1801.

Contact Information

Primary practice address
2130 Millburn Ave Ste D2 Maplewood NJ 07040-3749
Phone: (973) 801-1801
Fax: (908) 964-0809
Website:
Map and Directions
Authorized official contact:
Name: Baskerville-Williams, Kira MSW, LCSW, ED.S
Phone: (973) 801-1801

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X

Profile Details

NPI number 1912428905
LBN Legal business name Evolution Mind, Llc
DBA Doing business as
Authorized official Baskerville-Williams, Kira MSW, LCSW, ED.S
Entity Organization
Organization subpart 1 No
Enumeration date Jun 29th, 2017
Last updated Oct 23rd, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912428905 NPPES
New Jersey Other 1336699529 NPI

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