Provider Demographics
NPI:1336740653
Name:PERSONAL GROWTH SERVICES
Entity type:Organization
Organization Name:PERSONAL GROWTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:REINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-997-5091
Mailing Address - Street 1:57 METACOMET RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1801
Mailing Address - Country:US
Mailing Address - Phone:860-997-5091
Mailing Address - Fax:
Practice Address - Street 1:57 METACOMET RD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1801
Practice Address - Country:US
Practice Address - Phone:860-997-5091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-03
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health