EVOLVE RESIDENTIAL LLC NPI 1043957137

NPI Information

  • NPI: 1043957137
  • Provider Name: EVOLVE RESIDENTIAL LLC
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Organization
  • Address: 6305 CAROLINA AVE
    GLEN BURNIE, MD
    ZIP 21061
  • Phone: (443) 548-3733

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NPI Details

EVOLVE RESIDENTIAL LLC is a substance abuse rehabilitation facility in Glen Burnie, MD. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. EVOLVE RESIDENTIAL LLC NPI is 1043957137. The provider is registered as an organization entity type.

The provider's business location address is:

6305 CAROLINA AVE
GLEN BURNIE, MD
ZIP 21061-601
Phone: (443) 548-3733

The provider's authorized official is Jessie Costley .
The authorized official title is Licensing & Credentialing Specialis and has the following contact phone number (443) 548-3733.

The enumeration date for this NPI number is 5/19/2022 and was last updated on 7/13/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1324500000XSubstance Abuse Rehabilitation FacilityYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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