Provider Demographics
NPI:1992345169
Name:GROWING MINDS LLC
Entity type:Organization
Organization Name:GROWING MINDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EARLY INTERVENTION PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMALLWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-668-4237
Mailing Address - Street 1:308 KENNETH MOORE LN
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:KY
Mailing Address - Zip Code:40145-7870
Mailing Address - Country:US
Mailing Address - Phone:270-668-4237
Mailing Address - Fax:
Practice Address - Street 1:308 KENNETH MOORE LN
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:KY
Practice Address - Zip Code:40145-7870
Practice Address - Country:US
Practice Address - Phone:270-668-4237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency