Provider Demographics
NPI:1386498715
Name:EVANGELIA WOLD INC
Entity type:Organization
Organization Name:EVANGELIA WOLD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVANGELIA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:WOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-330-3841
Mailing Address - Street 1:4525 WHITE BEAR PKWY STE 128
Mailing Address - Street 2:
Mailing Address - City:WHITE BEAR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55110-7627
Mailing Address - Country:US
Mailing Address - Phone:651-330-3841
Mailing Address - Fax:651-330-3892
Practice Address - Street 1:4525 WHITE BEAR PKWY STE 128
Practice Address - Street 2:
Practice Address - City:WHITE BEAR LAKE
Practice Address - State:MN
Practice Address - Zip Code:55110-7627
Practice Address - Country:US
Practice Address - Phone:651-330-3841
Practice Address - Fax:651-330-3892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care