Seeds of Love 1 LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

SEEDS OF LOVE 1 LLC

Practice address

2928 S 97TH LN
Tolleson, AZ 85353-8525

Phone

(319) 202-2573

Fax

(623) 777-0082

NPI assigned

Oct 22, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Aimable Seba Byishimo

Title

Owner

Phone

(319) 202-2573

Specialties & licenses 1

Addresses

Other names 1

• SEEDS OF LOVE 1 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634860800000",
    "number": "1104580596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 N 16TH ST STE 108",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061264",
            "telephone_number": "319-202-2573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2928 S 97TH LN",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853538525",
            "telephone_number": "319-202-2573",
            "fax_number": "623-777-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEEDS OF LOVE 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-22",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A",
        "authorized_official_last_name": "BYISHIMO",
        "authorized_official_first_name": "AIMABLE",
        "authorized_official_middle_name": "SEBA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-202-2573",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SEEDS OF LOVE 1",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hector Alexander Sandoval, PHARMD
• Donald Carl Scicchitano, RPA
• Jana Lynn Scott, FNP-BC
• Mavis Scott
• Jeremy Thomas Scotten, LMT
• Rachel M. Segovia
• Serene Surroundings Behavioral Home LLC
• Keith George Serrano, DDS
• Robin Kay Sharples-Ray, LM, CPM
• Shiva Shirvanifar

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Tolleson, AZ
• Providers in Tolleson, AZ by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.