Organization
ROOM FOR GROWTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAYLOR JESSICA WOODS (OWNER/CEO/DIRECTOR)
(510) 289-7211
Entity
Organization
Contact information
Practice address
208 WEIMAR ST, BUFFALO, NY 14206-3253
(510) 289-7211
Mailing address
653 MAYTIDE ST, PITTSBURGH, PA 15227-1731
(510) 289-7211
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
—
—
310400000X
Assisted Living Facility
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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