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General NPI Number Information
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NPI Number | 1679417166
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Entity Type | Organization
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Legal Business Name | SEED & SANCTUARY WELLNESS CENTER LLC
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 849 FAIRMOUNT AVE SUITE 200 #1018
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City | TOWSON
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State | MD
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Zip | 21286
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Country | US
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Telephone | 727-776-1625
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Fax |
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Provider Business Mailing Address
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Address Line | 849 FAIRMOUNT AVE SUITE 200 #1018
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City | TOWSON
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State | MD
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Zip | 21286
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Country | US
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Telephone | 727-776-1625
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | KYRAH ODUDU
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Credential | MA
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Telephone | 727-776-1625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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