Growing Wings Adult Services LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

GROWING WINGS ADULT SERVICES LLC

Practice address

107 5TH St SE Ste 8
Barberton, OH 44203-4269

Phone

(234) 334-7547

NPI assigned

Oct 29, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jodie L Dietry

Title

Office Manager

Phone

(234) 334-7547

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Growing Wings LLC Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1205436250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 5TH ST SE STE 8",
            "city": "BARBERTON",
            "state": "OH",
            "postal_code": "442034269",
            "telephone_number": "234-334-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 5TH ST SE STE 8",
            "city": "BARBERTON",
            "state": "OH",
            "postal_code": "442034269",
            "telephone_number": "234-334-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROWING WINGS ADULT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "DIETRY",
        "authorized_official_first_name": "JODIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "234-334-7547"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0194567",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF DEVELOPMENTAL DISABILITIES",
            "identifier": "8501722",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO SUPPLIER NUMBER",
            "identifier": "0000268699",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Growing Wings LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Amy L Gray, LPCC-S
• Jennifer Dawn Green, APRN-CNP
• Lisa Marie Greenaway, LPN
• Gagandip Grewal
• Michael D Gromofsky, PT
• Nicole Gruszewski, LPCC-S
• Angela Gumbarevic
• Andrew J Haas Jr., MD
• Meghan R Haas, R.PH.
• Jessica Hagan, PT

• Developmentally Disabled Services Day Training Agency in Barberton, OH
• Providers in Barberton, OH by specialty
• Developmentally Disabled Services Day Training Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.