Healthcare Provider Details

I. General information

NPI: 1093933947
Provider Name (Legal Business Name): WINTER GROWTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18110 PRINCE PHILIP DR
OLNEY MD
20832
US

IV. Provider business mailing address

18110 PRINCE PHILIP DR
OLNEY MD
20832
US

V. Phone/Fax

Practice location:
  • Phone: 301-774-7501
  • Fax: 301-774-2687
Mailing address:
  • Phone: 301-774-7501
  • Fax: 301-774-2687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number16279
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA ROGERS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 301-774-7501