Provider Demographics
NPI:1255176707
Name:EVOLVE COUNSELING AND TREATMENT CENTER
Entity type:Organization
Organization Name:EVOLVE COUNSELING AND TREATMENT CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:T
Authorized Official - Last Name:TANDANPOLIE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:614-537-4206
Mailing Address - Street 1:5340 E MAIN ST STE 106
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2574
Mailing Address - Country:US
Mailing Address - Phone:614-845-5018
Mailing Address - Fax:614-845-5019
Practice Address - Street 1:5340 E MAIN ST STE 106
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2574
Practice Address - Country:US
Practice Address - Phone:614-845-5018
Practice Address - Fax:614-845-5019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-26
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty