Provider Demographics
NPI:1720844319
Name:GIGGLE & GROW
Entity Type:Organization
Organization Name:GIGGLE & GROW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:989-494-8611
Mailing Address - Street 1:210 W 5TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:IMLAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48444-1037
Mailing Address - Country:US
Mailing Address - Phone:989-494-8611
Mailing Address - Fax:
Practice Address - Street 1:210 W 5TH ST FL 1
Practice Address - Street 2:
Practice Address - City:IMLAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48444-1037
Practice Address - Country:US
Practice Address - Phone:989-494-8611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency