Provider Demographics
NPI:1457503088
Name:GROWING MINDS LEARNING SERVICES, INC.
Entity Type:Organization
Organization Name:GROWING MINDS LEARNING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER- EDUCATIONAL SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PALAGANAS
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:248-854-3699
Mailing Address - Street 1:5852 DARB LAKE DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-2105
Mailing Address - Country:US
Mailing Address - Phone:248-763-5350
Mailing Address - Fax:
Practice Address - Street 1:5852 DARB LAKE DR
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48324-2105
Practice Address - Country:US
Practice Address - Phone:248-763-5350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI244956385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child