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General NPI Number Information
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NPI Number | 1114660354
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Entity Type | Organization
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Legal Business Name | GROWING HEARTS LLC
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Dates
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Enumeration Date | 04/15/2022
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 43970 CHOPTANK TER
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City | ASHBURN
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State | VA
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Zip | 20147-3939
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Country | US
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Telephone | 703-587-3545
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Fax |
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Provider Business Mailing Address
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Address Line | 43970 CHOPTANK TER
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City | ASHBURN
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State | VA
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Zip | 20147-3939
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | SARAH MATHEW
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Credential |
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Telephone | 703-587-3545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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