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General NPI Number Information
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NPI Number | 1386978385
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Entity Type | Organization
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Legal Business Name | GROWTH WORKS INC.
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Dates
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Enumeration Date | 09/23/2009
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 271 S MAIN ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-1637
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Country | US
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Telephone | 734-455-4095
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Fax | 734-455-2664
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Provider Business Mailing Address
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Address Line | 271 S MAIN ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-1637
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Country | US
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Telephone | 734-455-4095
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Fax | 734-455-2664
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | DEANNA M WHEELER
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Credential |
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Telephone | 248-216-6451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 820019
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253J00000X
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Taxonomy Name | Foster Care Agency
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License Number | CB820250537
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | CB820250537
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License Number State | MI
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