Provider Demographics
NPI:1679715049
Name:SMARTSEEDS INC.
Entity type:Organization
Organization Name:SMARTSEEDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:MAINOR
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-797-7354
Mailing Address - Street 1:428 ST THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-2975
Mailing Address - Country:US
Mailing Address - Phone:910-797-7354
Mailing Address - Fax:
Practice Address - Street 1:110 MAIN STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-4060
Practice Address - Country:US
Practice Address - Phone:910-797-7354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-01
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health