NPIMap

Organization Active NPI

Evolve Behavioral Health

  • Psychiatric Residential Treatment Facility
  • Fort Myers, FL
National Provider Identifier
1649813858
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
Legal business name
EVOLVE BEHAVIORAL HEALTH
Practice address
3331 E Riverside Dr
Fort Myers, FL 33916-1457
Phone
(239) 880-3990
NPI assigned
Oct 21, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Authorized official

Name
Brian Walowitz
Title
Director of Technology
Phone
(239) 880-3990

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X
Psychiatric Residential Treatment Facility 323P00000X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

3331 E Riverside Dr
Fort Myers, FL 33916-1457

Mailing address

3331 E Riverside Dr
Fort Myers, FL 33916-1457
Phone (239) 880-3990

Other names 1

  • Celadon Recovery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Celadon Recovery2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643846400000",
    "number": "1649813858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3331 E RIVERSIDE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339161457",
            "telephone_number": "239-880-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3331 E RIVERSIDE DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339161457",
            "telephone_number": "239-880-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-21",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A",
        "authorized_official_last_name": "WALOWITZ",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "DIRECTOR OF TECHNOLOGY",
        "authorized_official_telephone_number": "239-880-3990"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Celadon Recovery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Celadon Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.