Provider Demographics
NPI:1063586527
Name:SEEDS OF HOPE, LLC
Entity type:Organization
Organization Name:SEEDS OF HOPE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CHIEF ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:T
Authorized Official - Last Name:ASOMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-753-6569
Mailing Address - Street 1:PO BOX 93262
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30377-0262
Mailing Address - Country:US
Mailing Address - Phone:404-753-6569
Mailing Address - Fax:404-755-6731
Practice Address - Street 1:581 GARDEN WALK BLVD
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-6675
Practice Address - Country:US
Practice Address - Phone:404-753-6569
Practice Address - Fax:404-755-6731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000720101ALMedicaid
GA000720101ATMedicaid
GA000720101AXMedicaid
GA000720101ASMedicaid
GA000720101ANMedicaid
GA000720101SMedicaid
GA000720101WMedicaid
GA000720101AOMedicaid
GA000720101XMedicaid
GA000720101AYMedicaid
GA000720101AHMedicaid
GA000720101BBMedicaid