Provider Demographics
NPI:1821791096
Name:GROWTH & HEALING SERVICES
Entity Type:Organization
Organization Name:GROWTH & HEALING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHALA
Authorized Official - Middle Name:ABDUSALAM
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-466-1989
Mailing Address - Street 1:1613 128TH LN NW
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55448-1573
Mailing Address - Country:US
Mailing Address - Phone:612-466-1989
Mailing Address - Fax:
Practice Address - Street 1:1613 128TH LN NW
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55448-1573
Practice Address - Country:US
Practice Address - Phone:612-466-1989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health