Guided Growth Therapy LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

GUIDED GROWTH THERAPY LLC

Practice address

2355 Highway 36 W Ste 400
Roseville, MN 55113-3905

Phone

(720) 850-2055

NPI assigned

Apr 12, 2024

Organization subpart

No

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

Authorized official

Name

Mustafa Mohamed Ali

Title

Co-Ceo

Phone

(720) 850-2055

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1712880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712880000000",
    "number": "1689428138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 400",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "720-850-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 400",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "720-850-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUIDED GROWTH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-12",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "MUSTAFA",
        "authorized_official_middle_name": "MOHAMED",
        "authorized_official_title_or_position": "CO-CEO",
        "authorized_official_telephone_number": "720-850-2055"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Group Health Plan Inc
• Group Health Plan, Inc
• Lisa Sue Grover, DNP, APRN, FNP-C
• Everett Gu, M.D.
• Guided Growth
• Kaitlen Gullicksrud, ATC/R
• Christine Ann Haas, COTA
• Patrick Hackler, M.D
• Tara Haefner
• Holly June Haehnel, CRNA

• Developmental Disabilities Clinic/Center in Roseville, MN
• Providers in Roseville, MN by specialty
• Developmental Disabilities Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; 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.