Provider Demographics
NPI:1699302356
Name:EVOLVE INDY LLC
Entity type:Organization
Organization Name:EVOLVE INDY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEASY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-648-2887
Mailing Address - Street 1:8770 GUION RD STE B
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-3017
Mailing Address - Country:US
Mailing Address - Phone:317-648-2887
Mailing Address - Fax:317-296-7513
Practice Address - Street 1:8770 GUION RD STE B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-3017
Practice Address - Country:US
Practice Address - Phone:317-648-2887
Practice Address - Fax:317-296-7513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility