Provider Demographics
NPI:1659579092
Name:GROWING UP FIT LLC
Entity Type:Organization
Organization Name:GROWING UP FIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-579-3743
Mailing Address - Street 1:GROWING UP FIT
Mailing Address - Street 2:PO BOX 112
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051
Mailing Address - Country:US
Mailing Address - Phone:716-818-8232
Mailing Address - Fax:
Practice Address - Street 1:GROWING UP FIT
Practice Address - Street 2:120 VIA FORESTA LANE
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221
Practice Address - Country:US
Practice Address - Phone:716-818-8232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)