Healthcare Provider Details

I. General information

NPI: 1528858024
Provider Name (Legal Business Name): GROW COUNSELING AND TRAINING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 S MARKET ST STE 205
ROGERS AR
72758-7700
US

IV. Provider business mailing address

12016 FARRAR RD
BENTONVILLE AR
72713-6667
US

V. Phone/Fax

Practice location:
  • Phone: 479-721-1292
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER SIMON
Title or Position: VICE PRESIDENT
Credential:
Phone: 479-721-1292