# PROVIDIAN

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE MUSTARD SEED FOUNDATION
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1750517793
- **Legal business name:** THE MUSTARD SEED FOUNDATION
- **Authorized official:** MS. SHONDALE NICOLE ATKINSON (C.E.O.)
- **Authorized official phone:** (937) 603-6643

## Contact information

- **Practice address:** 2844 E RIVER RD, MORAINE, OH 45439-1538
- **Practice address phone:** (937) 603-6643
- **Mailing address:** 402 KATY LN, ENGLEWOOD, OH 45322-2302
- **Mailing address phone:** (937) 603-6643

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/04/2009
- **Last updated:** 06/04/2009