1639542038 NPI number — ENVOLVE PEOPLECARE, INC.

Table of content: (NPI 1639542038)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639542038 NPI number — ENVOLVE PEOPLECARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ENVOLVE PEOPLECARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FORMER LEGAL ENTITY NAME: NURSEWISE, LP; NEW DBA: NURSEWISE
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639542038
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 BATTERSON PARK ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMINGTON
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06032
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-677-8900
Provider Business Mailing Address Fax Number:
866-616-8773

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2802 E DISTRICT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85714-2081
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-225-2573
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/06/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CAVE
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT AND CEO
Authorized Official Telephone Number:
800-293-0056

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  UNC7335 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: UNC7335 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)