MEDICARE: GROW THERAPY NV LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1134997331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GROW THERAPY NV LLC

Provider Business Mailing Address
First Line	:	8910 W TROPICANA AVE STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-8131
Country	:	US
Telephone Number	:	702-292-2596
Fax Number	:

Provider Business Practice Location Address
First Line	:	8910 W TROPICANA AVE STE 1
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-8131
Country	:	US
Telephone Number	:	702-292-2596
Fax Number	:

Authorized Official
Title or Position	:	CEO/SPEECH PATHOLOGIST
Name	:	ANDREA JOY SIMS
Credential	:
Telephone Number	:	702-604-9797

Provider Enumeration Date	:	12/18/2023
Last Update Date	:	12/18/2023

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Directions to “GROW THERAPY NV LLC ” Practice Location

Language	Start Address	Practice Location

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