Organization
EVOLUTION THERAPEUTIC HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAMONT JONES (CEO)
(443) 570-5027
Entity
Organization
Contact information
Practice address
9500 MEDICAL CENTER DR STE 420, LARGO, MD 20774-3716
(240) 490-3177
Mailing address
407 RED MEADOWS CT, REISTERSTOWN, MD 21136-6229
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
06/18/2021
Last updated
06/18/2021
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