Organization
PROVIDIAN
Active
Organization
PROVIDIAN
Active
Parent organization
THE MUSTARD SEED FOUNDATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE MUSTARD SEED FOUNDATION
Authorized official
MS. SHONDALE NICOLE ATKINSON (C.E.O.)
(937) 603-6643
Entity
Organization
Contact information
Practice address
2844 E RIVER RD, MORAINE, OH 45439-1538
(937) 603-6643
Mailing address
402 KATY LN, ENGLEWOOD, OH 45322-2302
(937) 603-6643
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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