Healthcare Provider Details

I. General information

NPI: 1851202006
Provider Name (Legal Business Name): GRACIOUS GROWTH CT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 POST RD STE 200
FAIRFIELD CT
06824-6220
US

IV. Provider business mailing address

268 POST RD STE 200
FAIRFIELD CT
06824-6220
US

V. Phone/Fax

Practice location:
  • Phone: 844-408-3757
  • Fax:
Mailing address:
  • Phone: 844-408-3757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: AVI MARMORSTEIN
Title or Position: CEO
Credential:
Phone: 917-771-4207