Provider Demographics
NPI:1538722889
Name:SEEDS THERAPY CENTER
Entity type:Organization
Organization Name:SEEDS THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MACHADO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:619-990-2611
Mailing Address - Street 1:2707 CONGRESS ST STE 1R
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-2764
Mailing Address - Country:US
Mailing Address - Phone:619-299-3161
Mailing Address - Fax:619-900-7779
Practice Address - Street 1:2707 CONGRESS ST STE 1R
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-2764
Practice Address - Country:US
Practice Address - Phone:619-299-3161
Practice Address - Fax:619-900-7779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty