Evolution Life Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EVOLUTION LIFE SERVICES LLC

Practice address

420 W Broad St
Richmond, VA 23220-4221

Phone

(804) 681-2023

Fax

(804) 533-1498

NPI assigned

Sep 6, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Keesha L BordenNPI 1851177067

Title

Ceo

Phone

(804) 681-2023

Specialties & licenses 1

Addresses

Other names 1

• Evolution Life Services LLC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keesha L Borden

  • Clinical Social Worker
  • Richmond, VA
  • NPI 1851177067

  Community/Behavioral Health

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1144006107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6903 ALDER GROVE DR",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232282663",
            "telephone_number": "804-681-5331",
            "fax_number": "804-533-1498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W BROAD ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232204221",
            "telephone_number": "804-681-2023",
            "fax_number": "804-533-1498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION LIFE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-06",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "BORDEN",
        "authorized_official_first_name": "KEESHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-681-2023",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolution Life Services LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evolution Life Services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Terry Levon Everett
• Everglow Lantern Mindcare PLLC
• Robin S Everhart, PHD
• Joseph P Evers, M.D.
• Evok Wellness LLC
• David Ewell Jr.
• Colleen A Ewing, PH.D.
• Edward Ewing, D.O.
• William J Ewing
• Executive Health Group, PC

• Community/Behavioral Health Agency in Richmond, VA
• Providers in Richmond, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.