Provider Demographics
NPI:1548358757
Name:GROWING YEARS REHAB SERVICES INC
Entity type:Organization
Organization Name:GROWING YEARS REHAB SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FELOMENO
Authorized Official - Middle Name:RAMOS
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:OTR
Authorized Official - Phone:812-475-0864
Mailing Address - Street 1:3623 KEYSTONE HILLS DRIVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-2296
Mailing Address - Country:US
Mailing Address - Phone:812-475-0864
Mailing Address - Fax:812-475-0864
Practice Address - Street 1:3623 KEYSTONE HILLS DRIVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-2296
Practice Address - Country:US
Practice Address - Phone:812-475-0864
Practice Address - Fax:812-475-0864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05003390A225100000X
IN31001488A225X00000X
KYKYR1009225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty