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General NPI Number Information
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NPI Number | 1780365387
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Entity Type | Organization
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Legal Business Name | SEEDS OF HOPE BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 103 ROUTE 70 E STE 2
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City | MARLTON
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State | NJ
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Zip | 08053-1889
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Country | US
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Telephone | 856-264-4480
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Fax |
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Provider Business Mailing Address
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Address Line | 1 EVES DR STE 111
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City | MARLTON
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State | NJ
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Zip | 08053-3125
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Country | US
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Telephone | 856-264-4480
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Fax |
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Authorized Official
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Title or Position | DELEGATED OFFICIAL
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Name | MS. ABIOLA SABA
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Credential | PMHNP-BC
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Telephone | 856-264-4480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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