Organization
EVOLVE RESIDENTIAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA BURDEN (EXECUTIVE DIRECTOR)
(410) 456-7404
Entity
Organization
Contact information
Practice address
394 WASHINGTON AVE, GLEN BURNIE, MD 21060-8712
(410) 456-7404
Mailing address
394 WASHINGTON AVE, GLEN BURNIE, MD 21060-8712
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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