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General NPI Number Information
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NPI Number | 1417690967
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Entity Type | Organization
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Legal Business Name | GROW AGAIN COUNSELING, LLC
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Dates
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Enumeration Date | 04/13/2022
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Last Update Date | 02/26/2024
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Provider Practice Location Address
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Address Line | 17817 VALENCIA BLVD
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City | LOXAHATCHEE
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State | FL
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Zip | 33470-2653
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Country | US
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Telephone | 954-773-3081
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Fax |
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Provider Business Mailing Address
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Address Line | 6317 NW 74TH AVE
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City | TAMARAC
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State | FL
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Zip | 33321-5510
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Country | US
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Telephone | 954-773-3081
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JORDAN JULES JOACHIM
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Credential |
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Telephone | 954-773-3081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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