Provider Demographics
NPI:1609573864
Name:GROWING CARE DEVELOPMENT SERVICES LLC
Entity Type:Organization
Organization Name:GROWING CARE DEVELOPMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SPONTANEOUS
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA,QMHP-A
Authorized Official - Phone:804-943-6246
Mailing Address - Street 1:3829 SEASONS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1603
Mailing Address - Country:US
Mailing Address - Phone:804-943-6246
Mailing Address - Fax:
Practice Address - Street 1:904 N 1ST ST STE 201
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-1000
Practice Address - Country:US
Practice Address - Phone:804-943-6246
Practice Address - Fax:804-533-0536
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GROWING CARE DEVELOPMENT SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty