NPIMap

Organization Active NPI

Evolution Therapeutic Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Largo, MD
National Provider Identifier
1285203992
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
EVOLUTION THERAPEUTIC HEALTH
Practice address
9500 Medical Center Dr Ste 420
Largo, MD 20774-3716
Phone
(240) 490-3177
NPI assigned
Jun 18, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lamont Jones
Title
Ceo
Phone
(443) 570-5027

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Children's Substance Abuse Rehabilitation Facility 3245S0500X

Addresses

Primary practice location

9500 Medical Center Dr Ste 420
Largo, MD 20774-3716

Mailing address

407 Red Meadows CT
Reisterstown, MD 21136-6229

National Provider Directory

National Provider Directory
Tax ID family
Evolution Therapeutic Health3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9500 Medical Center Dr
Ste 420
Upper Marlboro, MD 20774
Phone (240) 484-2069

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623974400000",
    "number": "1285203992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 RED MEADOWS CT",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211366229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 MEDICAL CENTER DR STE 420",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207743716",
            "telephone_number": "240-490-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION THERAPEUTIC HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "LAMONT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-570-5027"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.