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Contact Information

EVOLVE BRAIN HEALTH LLC
1055 SUMMER ST
STAMFORD, CT06905-5527
 Phone: 203-504-9758
 Fax: 203-504-9758
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Mental Health (Including Community Mental Health Center)

261QM0801X B4[14] Community Mental Health Center
Indicates primary specialty

NPI Profile & details for EVOLVE BRAIN HEALTH LLC

NPI Number 1740916105
LBN Legal business name EVOLVE BRAIN HEALTH LLC
Authorized official THOMAS KNIGHTLY - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/28/2022
Last updated 09/30/2024 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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