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Organization
EVOLVE GROWTH INITIATIVES LLC
Active
Organization
EVOLVE GROWTH INITIATIVES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDY LAI (CONTROLLER)
(424) 290-3341
Entity
Organization
Contact information
Practice address
820 MORAGA DR, LOS ANGELES, CA 90049-1632
(424) 281-5000
Mailing address
300 N PACIFIC COAST HWY STE 2060, EL SEGUNDO, CA 90245-4479
(772) 361-9705
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
06/06/2014
Last updated
08/20/2020
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