Provider Demographics
NPI:1124896972
Name:GRIN GRANT INC
Entity type:Organization
Organization Name:GRIN GRANT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:HELEN
Authorized Official - Last Name:SHASHY
Authorized Official - Suffix:
Authorized Official - Credentials:APSS
Authorized Official - Phone:859-629-1215
Mailing Address - Street 1:2905 CANDLELIGHT WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2825
Mailing Address - Country:US
Mailing Address - Phone:859-629-1214
Mailing Address - Fax:
Practice Address - Street 1:2905 CANDLELIGHT WAY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-2825
Practice Address - Country:US
Practice Address - Phone:859-629-1214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty