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General NPI Number Information
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NPI Number | 1093332801
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Entity Type | Organization
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Legal Business Name | HOPE SEED SUPPORT CENTER
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Dates
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Enumeration Date | 06/26/2020
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 10103 EARLINGTON MANOR DR
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City | SPRING
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State | TX
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Zip | 77379-7459
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Country | US
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Telephone | 281-883-8048
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Fax | 949-655-7811
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Provider Business Mailing Address
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Address Line | 10103 EARLINGTON MANOR DR
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City | SPRING
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State | TX
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Zip | 77379-7459
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Country | US
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Telephone | 281-883-8048
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Fax | 949-655-7811
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. AIMEE MEDINA
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Credential | BBS
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Telephone | 281-883-8048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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