Provider Demographics
NPI:1720539133
Name:SEEDS OF GROWTH TREATMENT CENTER, LLC
Entity Type:Organization
Organization Name:SEEDS OF GROWTH TREATMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-497-9206
Mailing Address - Street 1:3202 MIDLOTHIAN TURNPIKE, SUITE F
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224
Mailing Address - Country:US
Mailing Address - Phone:804-497-9206
Mailing Address - Fax:
Practice Address - Street 1:3202 MIDLOTHIAN TPKE APT F
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-1869
Practice Address - Country:US
Practice Address - Phone:804-497-9206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health