Provider Demographics
NPI:1790576650
Name:SEEDS TO GROW LLC
Entity type:Organization
Organization Name:SEEDS TO GROW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AVIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:ITDS
Authorized Official - Phone:954-391-3710
Mailing Address - Street 1:3909 E WOODSCAPE DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6631
Mailing Address - Country:US
Mailing Address - Phone:954-391-3710
Mailing Address - Fax:
Practice Address - Street 1:3909 E WOODSCAPE DR
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6631
Practice Address - Country:US
Practice Address - Phone:954-391-3710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency