Organization Active NPI

Evolve Growth Initiatives LLC

  • Mental Illness Community Based Residential Treatment Facility
  • Gilroy, CA
National Provider Identifier
1669985867
Registry record updated Aug 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
EVOLVE GROWTH INITIATIVES LLC
Practice address
2560 Butch Dr
Gilroy, CA 95020
Phone
(424) 281-5000
NPI assigned
Nov 9, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2020

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

Authorized official

Name
Eddy Lai
Title
Controller
Phone
(772) 361-9705

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
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

2560 Butch Dr
Gilroy, CA 95020

Mailing address

300 N Pacific Coast Hwy Ste 2060
El Segundo, CA 90245-4479
Phone (772) 361-9705

Other names 1

  • Evolve Treatment Centers - Gilroy Other name

National Provider Directory

National Provider Directory
Tax ID family
Evolve Growth Initiatives LLC27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1510185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597881600000",
    "number": "1669985867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N PACIFIC COAST HWY STE 2060",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902454479",
            "telephone_number": "772-361-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 BUTCH DR",
            "city": "GILROY",
            "state": "CA",
            "postal_code": "95020",
            "telephone_number": "424-281-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE GROWTH INITIATIVES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-09",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A",
        "authorized_official_last_name": "LAI",
        "authorized_official_first_name": "EDDY",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "772-361-9705"
    },
    "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": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evolve Treatment Centers - Gilroy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gilroy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2020; 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.