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EVOLVE GROWTH INITIATIVES LLC NPI 1689114258


NPI Information

NPI: 1689114258
Provider Name: EVOLVE GROWTH INITIATIVES, LLC

Other Name: EVOLVE TREATMENT CENTERS - SAN DIEGO

Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

CLIA Number: 05D2145208

Address:
3702 VIA DE LA VALLE STE 202
DEL MAR, CA
ZIP 92014
Phone: (424) 281-5000
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EVOLVE GROWTH INITIATIVES, LLC is an adolescent and children mental health clinic center in Del Mar, CA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. EVOLVE GROWTH INITIATIVES, LLC NPI is 1689114258. The provider is registered as an organization entity type.
The provider Other Name Is Evolve Treatment Centers - San Diego.

The provider's business location address is:

3702 VIA DE LA VALLE STE 202
DEL MAR, CA
ZIP 92014-255
Phone: (424) 281-5000

The provider's authorized official is Eddy Lai .
The authorized official title is Cfo and has the following contact phone number (424) 290-3341.

The CLIA number assigned to this NPI record is 05D2145208 - other - residential trtmnt center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/2/2017 and was last updated on 9/29/2023.


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
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessNo
2323P00000XPsychiatric Residential Treatment FacilityNo
3324500000XSubstance Abuse Rehabilitation FacilityNo
43245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, ChildrenNo
5261QM0855XClinic/CenterAdolescent and Children Mental 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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