EVOLVE THERAPUETIC BEHAVIORAL HEALTH AND WELLNESS SERVICES


Address: 8507 Corona St, District Hts, MD 20747-1904
Phone: 3019961677

EVOLVE THERAPUETIC BEHAVIORAL HEALTH AND WELLNESS SERVICES (NPI# 1013579093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1013579093
Entity Type Organization
Organization Name EVOLVE THERAPUETIC BEHAVIORAL HEALTH AND WELLNESS SERVICES
Practice Address 8507 Corona St
District Hts
MD 20747-1904
Practice Telephone 3019961677
Mailing Telephone 3019961677
Enumeration Date 2019-07-01
Last Update Date 2019-07-01
Authorized Official Name JACQUELINE D HAMILTON (CEO)
Authorized Official Telephone 3019961677
Authorized Official Credential LCPC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0405X Clinic/Center
Specialization: Rehabilitation, Substance Use Disorder
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MD 4515124 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1538433313 Evolve Therapuetic Behavioral Health and Wellness Services Community/Behavioral Health 8507 Corona St, Forestville, MD 20747-1904 2012-02-27

Office Location

Street Address 8507 CORONA ST
City DISTRICT HTS
State MD
Zip Code 20747-1904

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Taxonomy Information

Taxonomy Code 261QR0405X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation, Substance Use Disorder

Taxonomy Definition

Definition to come...

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Competitor

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City DISTRICT HTS
Zip Code 20747

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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