NPIMap

Organization Active NPI

Evolve Residential, LLC

  • Substance Abuse Rehabilitation Facility
  • Millersville, MD
National Provider Identifier
1801494984
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
EVOLVE RESIDENTIAL, LLC
Practice address
8315 Veterans Hwy
Millersville, MD 21108-1421
Phone
(410) 456-7404
NPI assigned
Oct 12, 2020
Last updated
Oct 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Authorized official

Name
Sara BurdenNPI 1407393291
Title
Executive Director
Phone
(410) 456-7404

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X NU Primary

Addresses

Primary practice location

8315 Veterans Hwy
Millersville, MD 21108-1421

Mailing address

8315 Veterans Hwy
Millersville, MD 21108-1421

National Provider Directory

National Provider Directory
Tax ID family
Evolve Residential LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1801494984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8315 VETERANS HWY",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8315 VETERANS HWY",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081421",
            "telephone_number": "410-456-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLVE RESIDENTIAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A",
        "authorized_official_last_name": "BURDEN",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-456-7404"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.