Provider Demographics
NPI:1700918992
Name:GROUNDSWELL, LLC
Entity Type:Organization
Organization Name:GROUNDSWELL, LLC
Other - Org Name:COUNSELING AND RECOVERY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM SPONSOR/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:RICKARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-351-8585
Mailing Address - Street 1:28314 CALVERT RD
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-6167
Mailing Address - Country:US
Mailing Address - Phone:281-351-8585
Mailing Address - Fax:281-255-4757
Practice Address - Street 1:28314 CALVERT RD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-6167
Practice Address - Country:US
Practice Address - Phone:281-351-8585
Practice Address - Fax:281-255-4757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone