MEDICARE: EVERGROW BEHAVIORAL HEALTH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1174467559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERGROW BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	13516 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-3434
Country	:	US
Telephone Number	:	216-387-7553
Fax Number	:

Provider Business Practice Location Address
First Line	:	13516 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-3434
Country	:	US
Telephone Number	:	216-387-7553
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KHAILAH BIGSBY
Credential	:
Telephone Number	:	216-387-7553

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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Directions to “EVERGROW BEHAVIORAL HEALTH ” Practice Location

Language	Start Address	Practice Location

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