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EVOLVE GROWTH INITIATIVES LLC NPI 1730592643


NPI Information

NPI: 1730592643
Provider Name: EVOLVE GROWTH INITIATIVES LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
820 MORAGA DR
LOS ANGELES, CA
ZIP 90049
Phone: (424) 281-5000
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EVOLVE GROWTH INITIATIVES LLC is a substance abuse rehabilitation facility in Los Angeles, CA. 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 GROWTH INITIATIVES LLC NPI is 1730592643. The provider is registered as an organization entity type.

The provider's business location address is:

820 MORAGA DR
LOS ANGELES, CA
ZIP 90049-632
Phone: (424) 281-5000

The provider's authorized official is Aron Gittleson .
The authorized official title is Chief Executive Officer and has the following contact phone number (718) 931-9700.

The enumeration date for this NPI number is 6/9/2014 and was last updated on 11/18/2019.


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
1323P00000XPsychiatric Residential Treatment FacilityNo
2324500000XSubstance Abuse Rehabilitation FacilityYes
33245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, ChildrenNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
105D2086936OTHERCALIFORNIACLIA

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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