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Active NPI 1114689379 Organization (Entity Type 2)

Evca, Llc

Clinic/Center - Mental Health (Including Community Mental Health Center) • Wayne, MI

About Evca, Llc NPI 1114689379 Summary

Evca, Llc is a verified healthcare organization specializing in Clinic/Center - Mental Health (Including Community Mental Health Center) operating in Wayne, MI. Located at 5355 NEWBERRY ST, this facility provides patient care and medical services under National Provider Identifier (NPI) 1114689379.

Administrative operations and authorized compliance are overseen by Evette Carroll (Owner/Chief Executive Officer).

The facility is associated with 1 linked healthcare practitioner providing clinical services.

Facility Location & Contact Primary Location

Facility Address

5355 Newberry St

Wayne, MI 481842305

Telephone 3132073057

Authorized Official Information

Authorized Contact Name

MRS. Evette Carroll , LMSW

Title / Role

Owner/chief Executive Officer

Official Telephone

3132073057

Facility Classifications & Specialties

Clinic/Center - Mental Health (Including Community Mental Health Center) Primary Taxonomy

NUCC Taxonomy Code: 261QM0801X

Definition to come...

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

1 Linked

Social Worker - Clinical

Wayne, MI

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active October 05, 2021

NPI status registered as active in NPPES database

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Updated Practice Location October 05, 2021

Registered at 5355 NEWBERRY ST, WAYNE, MI 481842305 (Tel: 3132073057)

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Updated Business Mailing Address October 05, 2021

Registered at 5355 NEWBERRY ST, WAYNE, MI 481842305 (Tel: 3132073057)

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Organization / Clinic Name Updated October 05, 2021

Operating as EVCA, LLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) October 05, 2021

Clinic/Center

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Initial NPI Registration & Enumeration October 05, 2021

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

Verified patient ratings, healthcare experiences, and facility photos

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NPI Organization Metadata

NPI Number: 1114689379
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: October 05, 2021
Last Update: October 05, 2021

Mailing Address

5355 Newberry St

Wayne, MI 481842305

Phone: 3132073057

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.