EVOLVE BEHAVIORAL HEALTH LLC. (NPI# 1255819504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255819504 |
| Entity Type | Organization |
| Organization Name | EVOLVE BEHAVIORAL HEALTH LLC. |
| Practice Address |
5788 Ridge Rd Ste 3 Parma OH 44129 |
| Mailing Address |
5788 Ridge Rd Ste 3 Parma OH 44129-3162 |
| Practice Telephone | 4403405558 |
| Practice Fax Number | 4403405575 |
| Mailing Telephone | 4403405558 |
| Mailing Fax Number | 4403405575 |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2019-10-16 |
| Authorized Official Name | TRACI M BARNES (FOUNDER) |
| Authorized Official Telephone | 2163877277 |
| Authorized Official Credential | LCDC III |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 384632 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5788 Ridge Rd Ste 3, Parma, OH 44129 | 4403405558 | 4403405575 |
| Street Address |
5788 RIDGE RD STE 3 |
| City | PARMA |
| State | OH |
| Zip Code | 44129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285290411 | Heather Workman | Counselor | 5788 Ridge Rd Ste 3, Parma, OH 44129-3162 | 2019-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952755688 | Lauren Williams | Speech-Language Pathologist | 6907 Brownfield Drive, Parma, OH 44129 | 2016-04-19 |
| 1447611579 | Chidozie Odigwe | Student in an Organized Health Care Education/Training Program | 7007 Powers Boulevard, Parma, OH 44129 | 2016-03-17 |
| 1700296589 | Kellie Richardson | Home Health Aide | 8402 Deerfield Drive, Parma, OH 44129 | 2014-05-02 |
| 1285982843 | John Eugene Huron | Dentist | 5657 Ridge Road, Parma, OH 44129 | 2012-08-29 |
| 1952659682 | Rima Patel | Optometrist | 7101 Lassiter Dr., Parma, OH 44129 | 2012-08-28 |
| 1740570464 | Wig Fashions Inc | Durable Medical Equipment & Medical Supplies | 5466 Pearl Road, Parma, OH 44129 | 2011-04-14 |
| 1447490883 | Adam D. Wysocki | Chiropractor | 5348 Pearl Road, Parma, OH 44129 | 2009-02-25 |
| 1184888547 | Virginia Ruth Ripepi | Registered Nurse | 8003 Dorothy Avenue, Parma, OH 44129 | 2008-07-15 |
| 1871787879 | Roger Goomber | Anesthesiology | 6305 Powers Blvd, Mac 4, Parma, OH 44129 | 2007-09-01 |
| 1164636528 | Eric Lawrence Gordon | Dentist | 7441 W Ridgewood Dr, Suite 275, Parma, OH 44129 | 2007-05-09 |
| Find all providers in zip 44129 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 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.