1922191543 NPI number — ENVOLVE PEOPLECARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922191543 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:
Provider Other Organization Name Type Code:
6
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:
1922191543
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:
1501 WEST FOUNTAINHEAD PARKWAY
Provider Second Line Business Practice Location Address:
SUITE #201
Provider Business Practice Location Address City Name:
TEMPE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-317-2141
Provider Business Practice Location Address Fax Number:
866-616-8773
Provider Enumeration Date:
10/02/2006

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: 251B00000X , with the licence number:  BH-2636 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 947806 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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