Provider Demographics
NPI:1598316598
Name:GROW THERAPY NV
Entity Type:Organization
Organization Name:GROW THERAPY NV
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:702-292-2596
Mailing Address - Street 1:10540 HEADWIND AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6491
Mailing Address - Country:US
Mailing Address - Phone:702-292-2596
Mailing Address - Fax:
Practice Address - Street 1:9321 COLORFUL RAINBOW AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89166-3777
Practice Address - Country:US
Practice Address - Phone:702-292-2596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy