Healthcare Provider Details

I. General information

NPI: 1639047509
Provider Name (Legal Business Name): GROWING STARS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 N AIRMONT RD
SUFFERN NY
10901-5104
US

IV. Provider business mailing address

12 N AIRMONT RD
SUFFERN NY
10901-5104
US

V. Phone/Fax

Practice location:
  • Phone: 718-872-6051
  • Fax:
Mailing address:
  • Phone: 718-872-6051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SARAH WEBER
Title or Position: SPEECH THERAPIST
Credential:
Phone: 718-872-6051