Provider Demographics
NPI:1861941866
Name:SEEDS 2 NURTURE LLC
Entity type:Organization
Organization Name:SEEDS 2 NURTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:N
Authorized Official - Last Name:HARRIS-MARION
Authorized Official - Suffix:
Authorized Official - Credentials:M ED, RBT
Authorized Official - Phone:321-234-4964
Mailing Address - Street 1:111 CYRUS PL
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-5709
Mailing Address - Country:US
Mailing Address - Phone:910-388-9367
Mailing Address - Fax:
Practice Address - Street 1:111 CYRUS PL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5709
Practice Address - Country:US
Practice Address - Phone:910-388-9367
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-02
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRBT-15-09693106S00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or WelfareGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty