Evident Healthcare Management LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EVIDENT HEALTHCARE MANAGEMENT LLC

Practice address

940 Hastings Ave
St Paul Park, MN 55071-1315

Phone

(651) 300-0140

NPI assigned

Mar 21, 2024

Organization subpart

No

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

Authorized official

Name

Ngang Mou-Bayong

Title

Owner

Phone

(651) 300-0140

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752105600000",
    "number": "1265292593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 HASTINGS AVE",
            "city": "ST PAUL PARK",
            "state": "MN",
            "postal_code": "550711315",
            "telephone_number": "651-300-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 HASTINGS AVE",
            "city": "ST PAUL PARK",
            "state": "MN",
            "postal_code": "550711315",
            "telephone_number": "651-300-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVIDENT HEALTHCARE MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-21",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A",
        "authorized_official_last_name": "MOU-BAYONG",
        "authorized_official_first_name": "NGANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-300-0140"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Davis, MSW, LICSW, LADC
• Nikki Donnella Divirgilio, MSW, LGSW
• Dustin Dukart, D.C.
• Alissa Eischens, LICSW
• Jill Ellingson, MA, LMFT
• Evident Social Services LLC
• Evident Transport LLC
• Gentle Comfort Home Care LLC
• Noor Haji-Munye
• Haven Chemical Health

• Clinic/Center in St Paul Park, MN
• Providers in St Paul Park, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2025; 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.