Organization
EVOLVE LIFE CENTERS IOP LLC
Active
Parent organization
EVOLVE LIFE CENTERS IOP, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVOLVE LIFE CENTERS IOP, LLC
Authorized official
JESSIE COSTLEY (ADMINISTRATOR)
(443) 548-3733
Entity
Organization
Contact information
Practice address
4231 POSTAL CT STE 201, PASADENA, MD 21122-4474
(443) 548-3733
(410) 360-1675
Mailing address
2528 MOUNTAIN RD STE 204, PASADENA, MD 21122-7204
(443) 548-3733
(410) 360-1675
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200319801
—
MD
Enumeration date
11/02/2022
Last updated
06/06/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us