Provider Demographics
NPI:1891666178
Name:TIGER GROVE WELLNESS, LLP
Entity type:Organization
Organization Name:TIGER GROVE WELLNESS, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:TREADWELL
Authorized Official - Last Name:GROVER
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, FNP-C
Authorized Official - Phone:386-479-7955
Mailing Address - Street 1:334 SLIDING ROCK DR
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:SC
Mailing Address - Zip Code:29670-1866
Mailing Address - Country:US
Mailing Address - Phone:386-479-7955
Mailing Address - Fax:
Practice Address - Street 1:334 SLIDING ROCK DR
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:SC
Practice Address - Zip Code:29670-1866
Practice Address - Country:US
Practice Address - Phone:386-479-7955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty