Organization
EVOLUTIONS DETOX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN CHANG (PROGRAM DIRECTOR)
(818) 220-0234
Entity
Organization
Contact information
Practice address
8418 WILBUR AVE, NORTHRIDGE, CA 91324-4433
(747) 202-0028
(818) 279-2869
Mailing address
8418 WILBUR AVE, NORTHRIDGE, CA 91324-4433
(818) 220-0234
(818) 279-2869
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/17/2025
Last updated
03/24/2025
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