Evolve Growth Initiatives, LLC
Clinic/Center, Adolescent and Children Mental Health in Ventura, CA. Organization (NPI-2).
NPI number1972955649
StatusActive
Last updated in NPPESAug 20, 2020
Details
- NPI
- 1972955649
- Entity type
- Organization (NPI-2)
- Legal business name
- Evolve Growth Initiatives, LLC
- Organization subpart
- No
- Enumeration date
- Jul 6, 2016
- Certification date
- Aug 20, 2020
- Last updated
- Aug 20, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – | Yes |
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | – | – | |
| 323P00000X | Psychiatric Residential Treatment Facility | – | – | |
| 324500000X | Substance Abuse Rehabilitation Facility | – | – | |
| 3245S0500X | Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | – | – |
Other names
- Evolve Treatment Centers - Camarillo (Other Name)
Practice location
799 Camarillo Springs RoadVentura, CA 93012
Phone 424-281-5000
Mailing address
300 N Pacific Coast Hwy Ste 2060El Segundo, CA 90245-4479
Phone 772-361-9705
Authorized official
Eddy Lai
Controller
7723619705
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