Provider Demographics
NPI:1851112684
Name:EVOLVE MANAGED CARE SOLUTIONS
Entity type:Organization
Organization Name:EVOLVE MANAGED CARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCFANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-524-7134
Mailing Address - Street 1:410 UNIVERSITY PKWY STE 2000
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-6808
Mailing Address - Country:US
Mailing Address - Phone:706-524-7134
Mailing Address - Fax:706-247-7784
Practice Address - Street 1:410 UNIVERSITY PKWY STE 2000
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6808
Practice Address - Country:US
Practice Address - Phone:706-524-7134
Practice Address - Fax:706-247-7784
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EVOLVE MANAGED CARE SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-23
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealthGroup - Single Specialty