Provider Demographics
NPI:1750863858
Name:THE GROWING TREE
Entity Type:Organization
Organization Name:THE GROWING TREE
Other - Org Name:THE GROWING TREE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:517-879-9756
Mailing Address - Street 1:818 WINIFRED ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-3062
Mailing Address - Country:US
Mailing Address - Phone:517-513-3617
Mailing Address - Fax:
Practice Address - Street 1:818 WINIFRED ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-3062
Practice Address - Country:US
Practice Address - Phone:517-513-3617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARBOR HILLS PSYCHOLOGICAL SERVICES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-09-05
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty