Provider Demographics
NPI:1699457143
Name:WEEVOLVE LLC
Entity type:Organization
Organization Name:WEEVOLVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DISTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-256-4867
Mailing Address - Street 1:2679 W MAIN ST STE 710
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-1950
Mailing Address - Country:US
Mailing Address - Phone:623-256-4867
Mailing Address - Fax:
Practice Address - Street 1:2679 W MAIN ST STE 710
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-1950
Practice Address - Country:US
Practice Address - Phone:623-256-4867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-03
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No347C00000XTransportation ServicesPrivate Vehicle