Organization
EVOLVE GROWTH INITIATIVES LLC
Active
Other names
Evolve Teen Treatment - Agoura Hills, Evolve Treatment Centers - Agoura Hills
Organization subpart
No
Provider details
NPI number
Authorized official
EDDY LAI (CFO)
(424) 290-3341
Entity
Organization
Contact information
Practice address
6425 CHESEBRO RD, AGOURA HILLS, CA 91301-1803
(855) 490-0302
Mailing address
360 N PACIFIC COAST HWY STE 1010, EL SEGUNDO, CA 90245-4413
(424) 290-3360
(424) 290-3355
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
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
—
05D2126813
CLIA
CA
01
—
198209044
STATE LICENSE
CA
01
—
198209703
CCLD
CA
Enumeration date
10/24/2016
Last updated
03/24/2026
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