Provider Demographics
NPI:1184509150
Name:GO GROW 1 INC
Entity type:Organization
Organization Name:GO GROW 1 INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HR
Authorized Official - Middle Name:
Authorized Official - Last Name:DIRECTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-746-1068
Mailing Address - Street 1:28 VALLEY RD STE 1
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2709
Mailing Address - Country:US
Mailing Address - Phone:914-746-1068
Mailing Address - Fax:
Practice Address - Street 1:28 VALLEY RD STE 1
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2709
Practice Address - Country:US
Practice Address - Phone:914-746-1068
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-08
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty