Provider Demographics
NPI:1306691589
Name:VANESSA EVANS, INC.
Entity type:Organization
Organization Name:VANESSA EVANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:VANNESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-201-2225
Mailing Address - Street 1:1000 W 8TH ST APT 1926
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-5930
Mailing Address - Country:US
Mailing Address - Phone:409-201-2225
Mailing Address - Fax:
Practice Address - Street 1:1000 W 8TH ST UNIT 1926
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-5930
Practice Address - Country:US
Practice Address - Phone:409-201-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management