Provider Demographics
NPI:1487193827
Name:GROWING FORWARD, INC.
Entity Type:Organization
Organization Name:GROWING FORWARD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURI
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-596-8830
Mailing Address - Street 1:111 PAWCATUCK AVE
Mailing Address - Street 2:
Mailing Address - City:PAWCATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06379-2432
Mailing Address - Country:US
Mailing Address - Phone:401-596-8830
Mailing Address - Fax:401-596-8802
Practice Address - Street 1:21 CANAL ST
Practice Address - Street 2:#201
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-1587
Practice Address - Country:US
Practice Address - Phone:401-596-8830
Practice Address - Fax:401-596-8802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00300101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty