MEDICARE: SEED & SANCTUARY WELLNESS CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	174H00000X	Health Educator

General Provider Information

NPI Number	:	1679417166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEED & SANCTUARY WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	849 FAIRMOUNT AVE
Second Line	:	SUITE 200 #1018
City	:	TOWSON
State	:	MD
Zip	:	21286
Country	:	US
Telephone Number	:	727-776-1625
Fax Number	:

Provider Business Practice Location Address
First Line	:	849 FAIRMOUNT AVE
Second Line	:	SUITE 200 #1018
City	:	TOWSON
State	:	MD
Zip	:	21286
Country	:	US
Telephone Number	:	727-776-1625
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	KYRAH ODUDU
Credential	:	MA
Telephone Number	:	727-776-1625

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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