Provider Demographics
NPI:1083507628
Name:GLOW AND GROW CO LLC
Entity type:Organization
Organization Name:GLOW AND GROW CO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOULA
Authorized Official - Prefix:
Authorized Official - First Name:ELEXUS
Authorized Official - Middle Name:BEATRICE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-894-2483
Mailing Address - Street 1:288 BLOOMFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0510
Mailing Address - Country:US
Mailing Address - Phone:248-894-2483
Mailing Address - Fax:
Practice Address - Street 1:288 BLOOMFIELD BLVD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0510
Practice Address - Country:US
Practice Address - Phone:248-894-2483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty