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General NPI Number Information
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NPI Number | 1215841333
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Entity Type | Organization
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Legal Business Name | GROWING AWARENESS MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 2300 RIVERSIDE DR
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City | GREEN BAY
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State | WI
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Zip | 54301-1900
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Country | US
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Telephone | 920-371-6461
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 RIVERSIDE DR
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City | GREEN BAY
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State | WI
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Zip | 54301-1900
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Country | US
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Telephone | 920-371-6461
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | EDDIBERTO FLORES
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Credential | MSW, APSW
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Telephone | 920-371-6461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | NULL
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