Healthcare Provider Details

I. General information

NPI: 1114660354
Provider Name (Legal Business Name): GROWING HEARTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2022
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14713 WATERS SHORE DR
MIDLOTHIAN VA
23112-4365
US

IV. Provider business mailing address

14713 WATERS SHORE DR
MIDLOTHIAN VA
23112-4365
US

V. Phone/Fax

Practice location:
  • Phone: 703-587-3545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARAH HARVEY
Title or Position: DIRECTOR
Credential: MOT
Phone: 703-587-3545