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General NPI Number Information
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NPI Number | 1952479552
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Entity Type | Organization
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Legal Business Name | GROWING HOME SE
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 440 KNOX ABBOTT DR SUITE 370
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City | CAYCE
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State | SC
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Zip | 29033-4353
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Country | US
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Telephone | 803-791-5513
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Fax | 803-739-0301
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Provider Business Mailing Address
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Address Line | 440 KNOX ABBOTT DR SUITE 370
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City | CAYCE
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State | SC
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Zip | 29033-4353
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Country | US
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Telephone | 803-791-5513
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Fax | 803-739-0301
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Authorized Official
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Title or Position | VP OF FINANCE
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Name | MS. ROSE M LOPEZ
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Credential | CPA
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Telephone | 803-791-5513
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SR-0008300001-CPA
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License Number State | SC
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