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EVOLUTIONARY INTERVENTION LLC NPI 1679846505


NPI Information

NPI: 1679846505
Provider Name: EVOLUTIONARY INTERVENTION LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
17348 W 12 MILE RD
SUITE 106
SOUTHFIELD, MI
ZIP 48076
Phone: (888) 492-9386
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EVOLUTIONARY INTERVENTION LLC is a community behavioral health in Southfield, MI. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. EVOLUTIONARY INTERVENTION LLC NPI is 1679846505. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

17348 W 12 MILE RD
SUITE 106
SOUTHFIELD, MI
ZIP 48076-120
Phone: (888) 492-9386
Fax: (888) 492-9386

The provider's authorized official is Sharon C Jackson .
The authorized official title is Owner and has the following contact phone number (888) 492-9386.

The enumeration date for this NPI number is 2/23/2012 and was last updated on 5/20/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YP2500XCounselorProfessionalNo
2251S00000XCommunity/Behavioral HealthYes

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: 4/28/2024

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