EVOLVE GROWTH INITIATIVES LLC (NPI# 1154872372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154872372 |
| Entity Type | Organization |
| Organization Name | EVOLVE GROWTH INITIATIVES LLC |
| Other Organization Name | EVOLVE TREATMENT CENTERS - AGOURA HILLS |
| Practice Address |
6425 Chesebro Road Agoura CA 91301 |
| Mailing Address |
300 N Pacific Coast Hwy Ste 2060 El Segundo CA 90245-4479 |
| Practice Telephone | 4242815000 |
| Mailing Telephone | 7723619705 |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2020-08-20 |
| Authorized Official Name | EDDY LAI (CONTROLLER) |
| Authorized Official Telephone | 7723619705 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| N | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities | ||
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | CLIA | 05D2126813 | 01 |
| CA | STATE LICENSE | 198209044 | 01 |
| Other Name | Type Code |
|---|---|
| Evolve Treatment Centers - Agoura Hills | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538244 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 10525 Fuerte Dr, La Mesa, CA 91941-4350 | 2020-11-05 |
| 1639711039 | Evolve Growth Initiatives LLC | Clinic/Center | 123 Brodia Way, Walnut Creek, CA 94598-4919 | 2019-10-17 |
| 1548802945 | Evolve Growth Initiatives LLC | Clinic/Center | 1261 Panorama Dr, Lafayette, CA 94549-2412 | 2019-10-17 |
| 1356857494 | Evolve Growth Initiatives LLC | Substance Abuse Rehabilitation Facility | 423 Woodbluff Rd, Calabasas, CA 91302 | 2017-12-27 |
| 1669985867 | Evolve Growth Initiatives LLC | Clinic/Center | 2560 Butch Dr, Gilroy, CA 95020 | 2017-11-09 |
| 1669906020 | Evolve Growth Initiatives LLC | Clinic/Center | 5435 Aura Avenue, Tarzana, CA 91356 | 2017-04-12 |
| 1245682087 | Evolve Growth Initiatives LLC | Clinic/Center | 599 Quail Oaks Dr, Ojai, CA 93023 | 2016-07-05 |
| 1912310947 | Evolve Growth Initiatives LLC | Clinic/Center | 820 Moraga Dr, Los Angeles, CA 90049-1632 | 2014-06-06 |
| 1922581297 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 1991 Park Ave, San Jose, CA 95126-1423 | 2018-09-12 |
| 1033639307 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 4810 Azucena Rd, Woodland Hills, CA 91364-4040 | 2017-06-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | EVOLVE GROWTH INITIATIVES LLC | 820 Moraga Dr, Los Angeles, CA 90049 |
| Street Address |
6425 CHESEBRO ROAD |
| City | AGOURA |
| State | CA |
| Zip Code | 91301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770126823 | Krista Marie Windisch | Technician | 5836 Stonecrest Drive, Agoura, CA 91301 | 2019-10-22 |
| 1760851224 | Robert Kevin Ryan | Counselor | 28310 Roadside Drive Suite 235, Agoura Hills, CA 91301 | 2015-09-15 |
| 1922484054 | Mahyar Okhovat, M.d. Inc | Psychiatry & Neurology | 2925 Canwood St, 109, Agoural Hills, CA 91301 | 2015-07-30 |
| 1982083929 | Alfred Charles Deciutiis Jr. | Internal Medicine | 32062 1/2 Lobo Canyon, Agoura, CA 91301 | 2015-05-22 |
| 1821401787 | Brandie Boghosian | Psychologist | 30200 Agoura Rd Ste 190, Agoura, CA 91301 | 2014-06-09 |
| 1114339041 | Unique Care Los Angeles Hospice, Inc. | Hospice Care, Community Based | 27001 Agoura Rd #110, Calabasas, CA 91301 | 2014-05-27 |
| 1588905574 | Irit Almog | Marriage & Family Therapist | 5308 Derry Ave Ste L201, Agoura Hills, CA 91301 | 2013-03-15 |
| 1902152507 | Bethany Vaudrey | Psychologist | 28328 Agoura Rd Ste 102, Agoura Hills, CA 91301 | 2012-08-01 |
| 1508142472 | Jill Torres | Psychologist | 28729 Roadside Dr Ste 151, Agoura Hills, CA 91301 | 2011-10-24 |
| 1033431655 | Laura Lapiana | Psychologist | 5012 Chesebro Rd Ste 100, Agoura Hills, CA 91301 | 2010-02-23 |
| Find all providers in zip 91301 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538244 | Evolve Growth Initiatives LLC | Community Based Residential Treatment Facility, Mental Illness | 10525 Fuerte Dr, La Mesa, CA 91941-4350 | 2020-11-05 |
| 1154922458 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 24171 Grayston Dr, Lake Forest, CA 92630-3839 | 2020-11-03 |
| 1003417684 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 1155 Hoover St, Carlsbad, CA 92008-4230 | 2020-11-02 |
| 1497356075 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 405 N Tremont St, Oceanside, CA 92054-2535 | 2020-11-02 |
| 1467053041 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 6477 Goldenbush Dr, Carlsbad, CA 92011-4203 | 2020-11-02 |
| 1366043937 | A Better Life Recovery LLC | Community Based Residential Treatment Facility, Mental Illness | 26065 Waterwheel Pl, Laguna Hills, CA 92653-6114 | 2020-11-02 |
| 1730780313 | Orchid Court, Inc. | Community Based Residential Treatment Facility, Mental Illness | 307 S Arrowhead Avenue, San Bernardino, CA 92408-1325 | 2020-11-02 |
| 1477151199 | Inspiring Pathways, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1798 Bryman St, Hanford, CA 93230-7144 | 2020-10-14 |
| 1356949226 | Wings Recovery Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3134 Morningside Dr, Oceanside, CA 92056-4401 | 2020-10-13 |
| 1326645904 | New Passages Group Home, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5675 E Ashlan Ave, Fresno, CA 93727-7220 | 2020-10-06 |
| Find all providers with the same taxonomy | ||||
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| 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.