NPIMap

Organization Active NPI

Eva Life Giver Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Essex, MD
National Provider Identifier
1801345277
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
906059 Issued in MD
Legal business name
EVA LIFE GIVER INC.
Practice address
1528 Country Ridge LN
Essex, MD 21221-3906
Phone
(410) 661-0800
Fax
(410) 665-0400
NPI assigned
Sep 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

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

Authorized official

Name
Ms. Eva G. Devaughn
Title
Executive Director
Phone
(443) 271-8046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 906059 MD Primary

Addresses

Primary practice location

1528 Country Ridge LN
Essex, MD 21221-3906

Mailing address

5003 Ardmore Way
Baltimore
Baltimore, MD 21206-5004
Phone (443) 271-8046

Other identifiers 2

IdentifierTypeStateIssuer
1447619507MedicaidMD
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

1528 Country Ridge Ln
Essex, MD 21221
Phone (410) 574-1555

8035 Harford Rd
Ste C
Parkville, MD 21234

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1801345277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5003 ARDMORE WAY",
            "address_2": "BALTIMORE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212065004",
            "telephone_number": "443-271-8046",
            "fax_number": "443-873-8959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 COUNTRY RIDGE LN",
            "city": "ESSEX",
            "state": "MD",
            "postal_code": "212213906",
            "telephone_number": "410-661-0800",
            "fax_number": "410-665-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVA LIFE GIVER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-27",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "DEVAUGHN",
        "authorized_official_first_name": "EVA",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "443-271-8046",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "906059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447619507",
            "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"
        },
        {
            "organization_name": "DeVaughn Intervention Teach and Treat Options",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Essex, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; 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.