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General NPI Number Information
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NPI Number | 1558968099
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Entity Type | Organization
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Legal Business Name | SEED SOWER LLC
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 11526 W BLOOMFIELD RD
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City | EL MIRAGE
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State | AZ
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Zip | 85335-3916
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Country | US
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Telephone | 206-859-0123
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Fax |
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Provider Business Mailing Address
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Address Line | 11526 W BLOOMFIELD RD
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City | EL MIRAGE
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State | AZ
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Zip | 85335-3916
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER AND DIRECTOR OF OPERATIONS
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Name | NATHAN L JACKSON
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Credential | BHT, MHA
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Telephone | 206-859-0123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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