Active NPI
Evolve Growth Initiatives LLC
- Mental Illness Community Based Residential Treatment Facility
- Encinitas, CA
National Provider Identifier
1063185809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Illness Community Based Residential Treatment Facility
- Legal business name
- EVOLVE GROWTH INITIATIVES LLC
- Practice address
- 985 Dove Song Way
Encinitas, CA 92024-6852 - Phone
- (855) 490-0302
- NPI assigned
- Jul 28, 2021
- Organization subpart
- Yes
- Parent organization
- EVOLVE GROWTH INITIATIVES LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eddy Lai
- Title
- Cfo
- Phone
- (424) 290-3360
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | |||
| Mental Illness Community Based Residential Treatment Facility | 320800000X | Primary | ||
| Psychiatric Residential Treatment Facility | 323P00000X | |||
| Substance Abuse Rehabilitation Facility | 324500000X | |||
| Children's Substance Abuse Rehabilitation Facility | 3245S0500X |
Addresses
Primary practice location
985 Dove Song Way
Encinitas, CA 92024-6852
Mailing address
360 N Pacific Coast Hwy Ste 1010
El Segundo, CA 90245-4413
Phone (424) 290-3360
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 374690027 | Other | CA | CCLD |
Other names 3
- Evolve Treatment Centers - Dove Song (Encinitas)
- Evolve Teen Treatment - Dove Song
- Evolve Treatment Centers - Dove Song
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2271797 | Evolve Treatment Centers-Dove Song | Certificate of waiver | Nov 7, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Evolve Growth Initiatives LLC
- Part of
- Evolve Growth Initiatives LLC
Other organizations with this tax ID 26
Organizations that report the same tax identification number in the National Provider Directory.
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-
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-
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- NPI 1154872372
-
- Mental Illness Community Based Residential Treatment Facility
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- NPI 1215538244
-
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- NPI 1245682087
-
- Adolescent and Children Mental Health Clinic/Center
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- NPI 1265033989
-
- Mental Illness Community Based Residential Treatment Facility
- Sacramento, CA
- NPI 1275329096
-
- Mental Illness Community Based Residential Treatment Facility
- Sacramento, CA
- NPI 1295317071
-
- Mental Illness Community Based Residential Treatment Facility
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- NPI 1356857494
-
- Mental Illness Community Based Residential Treatment Facility
- Encinitas, CA
- NPI 1427623396
-
- Mental Illness Community Based Residential Treatment Facility
- Danville, CA
- NPI 1548721186
-
- Mental Illness Community Based Residential Treatment Facility
- Lafayette, CA
- NPI 1548802945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627430400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1774310400000",
"number": "1063185809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360 N PACIFIC COAST HWY STE 1010",
"city": "EL SEGUNDO",
"state": "CA",
"postal_code": "902454413",
"telephone_number": "424-290-3360",
"fax_number": "424-290-3355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "985 DOVE SONG WAY",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920246852",
"telephone_number": "855-490-0302"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVOLVE GROWTH INITIATIVES LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "EVOLVE GROWTH INITIATIVES LLC",
"enumeration_date": "2021-07-28",
"last_updated": "2026-03-24",
"certification_date": "2026-03-24",
"status": "A",
"authorized_official_last_name": "LAI",
"authorized_official_first_name": "EDDY",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "424-290-3360"
},
"taxonomies": [
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": null,
"license": null,
"primary": true
},
{
"code": "323P00000X",
"taxonomy_group": "",
"desc": "Psychiatric Residential Treatment Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "324500000X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility",
"state": null,
"license": null,
"primary": false
},
{
"code": "3245S0500X",
"taxonomy_group": "",
"desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CCLD",
"identifier": "374690027",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Evolve Treatment Centers - Dove Song (Encinitas)",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Evolve Teen Treatment - Dove Song",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Evolve Treatment Centers - Dove Song",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Encinitas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.