Provider Demographics
NPI:1912766841
Name:GUIDED GROWTH THERAPY GROUP
Entity Type:Organization
Organization Name:GUIDED GROWTH THERAPY GROUP
Other - Org Name:GGTG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-619-3193
Mailing Address - Street 1:10900 ARTIST CT
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-2879
Mailing Address - Country:US
Mailing Address - Phone:661-619-3193
Mailing Address - Fax:
Practice Address - Street 1:22939 BANYAN PL UNIT 289
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91390-4266
Practice Address - Country:US
Practice Address - Phone:661-450-7558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient