MEDICARE: EVOLVE GROWTH INITIATIVES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	320800000X	Mental Illness Community Based Residential Treatment Facility
4	323P00000X	Psychiatric Residential Treatment Facility
5	324500000X	Substance Abuse Rehabilitation Facility
6	3245S0500X	Children's Substance Abuse Rehabilitation Facility
7	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1023564226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVOLVE GROWTH INITIATIVES LLC

Provider Business Mailing Address
First Line	:	300 N PACIFIC COAST HWY STE 2060
Second Line	:
City	:	EL SEGUNDO
State	:	CA
Zip	:	90245-4479
Country	:	US
Telephone Number	:	772-361-9705
Fax Number	:

Provider Business Practice Location Address
First Line	:	1029 STATE ST
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93101
Country	:	US
Telephone Number	:	424-281-1000
Fax Number	:

Authorized Official
Title or Position	:	CONTROLLER
Name	:	EDDY LAI
Credential	:
Telephone Number	:	772-361-9705

Provider Enumeration Date	:	08/28/2016
Last Update Date	:	08/20/2020

Similar Medicare Providers

1285598813 — ELYSE LENORE GROSSMAN
Practice Location Address:

111 E ARRELLAGA ST
SANTA BARBARA, CA
93101-1903

Practice Phone: 805-882-2400
Practice Fax:

1508423104 — MARISSA NAOMI LINDSAY M.S., CCC-SLP
Practice Location Address:

215 W MISSION ST
SANTA BARBARA, CA
93101-2820

Practice Phone: 805-284-4826
Practice Fax:

1669735981 — GABE DUDLEY PA-C
Practice Location Address:

1601 ANACAPA ST
SANTA BARBARA, CA
93101-1909

Practice Phone: 805-699-5183
Practice Fax:

1528845849 — SARA J MURDOCH AMFT
Practice Location Address:

924 ANACAPA ST STE 2R
SANTA BARBARA, CA
93101-7133

Practice Phone: 805-699-5696
Practice Fax:

1477222198 — ALBERT CORRIERI JR.
Practice Location Address:

629 STATE ST STE 203B
SANTA BARBARA, CA
93101-7071

Practice Phone: 805-214-4354
Practice Fax:

1306700521 — MERAKI MANAGEMENT - CA LLC
Practice Location Address:

111 W MICHELTORENA ST STE 210
SANTA BARBARA, CA
93101-8810

Practice Phone: 424-600-7798
Practice Fax: 669-777-6709

1528922697 — JAZMIN NICOLE ROSTAMI MA, AMFT
Practice Location Address:

123 W GUTIERREZ ST
SANTA BARBARA, CA
93101-3424

Practice Phone: 805-842-5148
Practice Fax:

Directions to “EVOLVE GROWTH INITIATIVES LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.