Provider Demographics
NPI:1649319476
Name:GROW-ASSOCIATES, INC.
Entity type:Organization
Organization Name:GROW-ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-408-4210
Mailing Address - Street 1:101 WALES AVE
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:MA
Mailing Address - Zip Code:02322-1006
Mailing Address - Country:US
Mailing Address - Phone:508-408-4210
Mailing Address - Fax:508-408-4215
Practice Address - Street 1:101 WALES AVE
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:MA
Practice Address - Zip Code:02322-1006
Practice Address - Country:US
Practice Address - Phone:508-408-4210
Practice Address - Fax:508-408-4215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1583251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303091Medicaid