Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health (Including Community Mental Health Center) |
261QM0801X | B4[14] | Community Mental Health Center | |
Adolescent and Children Mental Health |
261QM0855X | |||
Adult Mental Health |
261QM0850X | |||
Professional |
101YP2500X | |||
Psychiatric Residential Treatment Facility |
323P00000X |
| NPI # | 1821541137 |
| LBN Legal business name | EVOLVE LLC |
| Authorized official | ELLIOTT RICHELSON - (AUTHORIZED OFFICIAL) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/03/2016 |
| Last updated | 06/29/2023 - About 3 years ago |
| Identifiers | n/a |
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