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General NPI Number Information
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NPI Number | 1417596149
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Entity Type | Organization
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Legal Business Name | SEED OF LIFE SENIOR CARE LLC
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Dates
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Enumeration Date | 12/28/2019
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Last Update Date | 12/28/2019
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Provider Practice Location Address
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Address Line | 7709 YALTA WAY
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City | GAINESVILLE
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State | VA
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Zip | 20155-1983
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Country | US
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Telephone | 703-232-1424
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Fax |
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Provider Business Mailing Address
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Address Line | 7709 YALTA WAY
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City | GAINESVILLE
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State | VA
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Zip | 20155-1983
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Country | US
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Telephone | 703-232-1424
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINA GREEN
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Credential | LPN
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Telephone | 571-282-8107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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