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Organization
EVOLVE GROWTH INITIATIVES LLC
Active
Organization
EVOLVE GROWTH INITIATIVES LLC
Active
Other names
Evolve Adolescent Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
EDDY LAI (CHIEF FINANCIAL OFFICER)
(772) 361-9705
Entity
Organization
Contact information
Practice address
360 N PACIFIC COAST HWY STE 1010, EL SEGUNDO, CA 90245-4413
(855) 490-0302
Mailing address
360 N PACIFIC COAST HWY STE 1010, EL SEGUNDO, CA 90245-4413
(424) 290-3348
(424) 290-3355
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2086936
CLIA
CA
Enumeration date
06/09/2014
Last updated
03/24/2026
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