Provider Demographics
NPI:1831713536
Name:THOUGHT EVOLUTION LLC.
Entity type:Organization
Organization Name:THOUGHT EVOLUTION LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MARVIN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LCADC
Authorized Official - Phone:443-945-8581
Mailing Address - Street 1:1111 PARK AVE APT 410
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5608
Mailing Address - Country:US
Mailing Address - Phone:443-945-8581
Mailing Address - Fax:
Practice Address - Street 1:847 N MILTON AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-1613
Practice Address - Country:US
Practice Address - Phone:443-945-8581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THOUGHT EVOLUTION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-29
Last Update Date:2020-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder