Healthcare Provider Details

I. General information

NPI: 1790615631
Provider Name (Legal Business Name): LIVING SEED CONSULT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 US ROUTE 2 SUITE A
YORK ME
03909
US

IV. Provider business mailing address

439 US RTE 2 STE A
YORK ME
03909
US

V. Phone/Fax

Practice location:
  • Phone: 207-249-9230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. OLUWAKOREDE ADEMUYIWA OMOLOLA
Title or Position: MANAGER
Credential: NP
Phone: 207-852-8450