Provider Demographics
NPI:1447866769
Name:SEEDS OF HOPE AND HEALING LLC
Entity type:Organization
Organization Name:SEEDS OF HOPE AND HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARA NICOLASA
Authorized Official - Middle Name:NICOLASA
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-504-5808
Mailing Address - Street 1:1105 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-2341
Mailing Address - Country:US
Mailing Address - Phone:732-504-5808
Mailing Address - Fax:
Practice Address - Street 1:1105 LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-2341
Practice Address - Country:US
Practice Address - Phone:732-504-5808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health