Organization
THE MUSTARD SEED FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHONDALE NICOLE ATKINSON (CEO)
(937) 603-6643
Entity
Organization
Contact information
Practice address
4880 DENLINGER RD, TROTWOOD, OH 45426-2012
(937) 603-6643
Mailing address
4880 DENLINGER RD, TROTWOOD, OH 45426-2012
(937) 603-6643
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
174H00000X
Health Educator
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
04/01/2014
Last updated
11/30/2016
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