Provider Demographics
NPI:1366295602
Name:A SEED OF CHANGE MARRIAGE AND FAMILY THERAPY CENTER, INC.
Entity type:Organization
Organization Name:A SEED OF CHANGE MARRIAGE AND FAMILY THERAPY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSLYN
Authorized Official - Middle Name:J
Authorized Official - Last Name:REECE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:760-305-8008
Mailing Address - Street 1:2131 PALOMAR AIRPORT RD STE 202
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1433
Mailing Address - Country:US
Mailing Address - Phone:760-305-8008
Mailing Address - Fax:760-305-7115
Practice Address - Street 1:2131 PALOMAR AIRPORT RD STE 202
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-1433
Practice Address - Country:US
Practice Address - Phone:760-305-8008
Practice Address - Fax:760-305-7115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty