| Organization Name: | GROWING OAK LLC |
| NPI Number: | 1306195276 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LINDSAY LOEWE (MENTAL HEALTH & SUBSTANCE ABUSE) |
| Mailing Address: | 112 Watson St Ripon |
| State: | WI US |
| Postal Code: | 549711327 |
| Phone Number: | 9208960189 |
| Fax Number: | 9206943021 |
| NPI Enumeration Date: | 09/06/2012 |
| NPI Last Update Date: | 09/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 4622-125 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |