Healthcare Provider Details

I. General information

NPI: 1770430589
Provider Name (Legal Business Name): SPM GROWTH SOLUTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6388 SILVER STAR RD STE 2C
ORLANDO FL
32818-3235
US

IV. Provider business mailing address

6388 SILVER STAR RD STE 2C
ORLANDO FL
32818-3235
US

V. Phone/Fax

Practice location:
  • Phone: 407-490-0307
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KYLIE SMITH
Title or Position: CEO
Credential:
Phone: 407-920-4016