| Seedgrow Behavioral Services,llc | |
|
505 Heatherdown Way Riverdale GA 30274-3592 | |
| (678) 435-9214 | |
| Not Available |
| Full Name | Seedgrow Behavioral Services,llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 505 Heatherdown Way, Riverdale, Georgia |
| Authorized Official Name and Position | Stephanie Knox (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4045656029 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Seedgrow Behavioral Services,llc 505 Heatherdown Way Riverdale GA 30274-3592 Ph: (678) 435-9214 | Seedgrow Behavioral Services,llc 505 Heatherdown Way Riverdale GA 30274-3592 Ph: (678) 435-9214 |
| NPI Number | 1194188532 |
|---|---|
| Provider Enumeration Date | 04/02/2016 |
| Last Update Date | 04/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194188532 | NPI | - | NPPES |
| 1497116834 | Other | GA | NPI |
| 13604699 | Other | GA | CAQH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 01-14-17610 (Georgia) | Primary |
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