Provider Demographics
NPI:1467221796
Name:GROWTH WORKS BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:GROWTH WORKS BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:505-639-4769
Mailing Address - Street 1:11101 HAINES AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-4323
Mailing Address - Country:US
Mailing Address - Phone:505-270-3966
Mailing Address - Fax:
Practice Address - Street 1:8206 LOUISIANA BLVD NE STE A2196
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-1738
Practice Address - Country:US
Practice Address - Phone:505-363-3374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty