Provider Demographics
NPI:1629828850
Name:GROWTH ACCELERATED THERAPY, LLC
Entity Type:Organization
Organization Name:GROWTH ACCELERATED THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELIKOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:215-237-3060
Mailing Address - Street 1:55 BOTSFORD AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-5804
Mailing Address - Country:US
Mailing Address - Phone:215-237-3060
Mailing Address - Fax:203-693-4304
Practice Address - Street 1:55 BOTSFORD AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-5804
Practice Address - Country:US
Practice Address - Phone:203-450-4745
Practice Address - Fax:203-693-4304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)