Organization
EVOLVE THERAPUETIC HEALTH AND WELLNESS SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE D HAMILTON LCPC (CEO)
(301) 996-1677
Entity
Organization
Contact information
Practice address
16208 PENTERRA WAY, BOWIE, MD 20716-1919
(301) 996-1677
Mailing address
16208 PENTERRA WAY, BOWIE, MD 20716-1919
(301) 996-1677
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4515124
—
MD
Enumeration date
07/01/2019
Last updated
03/19/2024
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