NPIMap

Organization Active NPI

Eva Life Giver Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Baltimore, MD
National Provider Identifier
1619694346
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
EVA LIFE GIVER INC.
Practice address
5003 Ardmore Way
Baltimore, MD 21206-5004
Phone
(443) 271-8046
Fax
(443) 873-8959
NPI assigned
Oct 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Authorized official

Name
Mrs. Eva Devaughn-Buchanan, MS, CAC-AD, AS
Title
Ceo
Phone
(443) 271-8046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

5003 Ardmore Way
Baltimore, MD 21206-5004

Mailing address

4804 York Rd Ste 2
Baltimore, MD 21212-4401
Phone (443) 873-8958

Other identifiers 6

IdentifierTypeStateIssuer
1801345277MedicaidMD
1831622315MedicaidMD
14477619507MedicaidMD
1003210873MedicaidMD
1093248577MedicaidMD
1699076562MedicaidMD

Other names 1

  • DeVaughn Intervention Teach and Treat Options Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Devaughn Intervention Teach and Treat Options8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4804 York Rd
Ste 2
Baltimore, MD 21212
Phone (443) 873-8958

NPI Registry JSON

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1619694346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4804 YORK RD STE 2",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212124401",
            "telephone_number": "443-873-8958",
            "fax_number": "443-873-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5003 ARDMORE WAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065004",
            "telephone_number": "443-271-8046",
            "fax_number": "443-873-8959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVA LIFE GIVER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "DEVAUGHN-BUCHANAN",
        "authorized_official_first_name": "EVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-271-8046",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, CAC-AD, AS"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1801345277",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831622315",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14477619507",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003210873",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093248577",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699076562",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeVaughn Intervention Teach and Treat Options",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.