NPI 1063802205

Seeds of Gaia LLC

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Mesa, AZ

Practice location

Address: 455 S Mesa Dr Unit 142, Mesa, AZ 85210-2711
Phone: (480) 277-0313
Mailing address: PO Box 4252, Mesa, AZ 85211-4252

Authorised official

Name: Moise Kelly
Title: President
Phone: (480) 277-0313

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence L-1744233-1 (AZ)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Arizona →

Registry record

NPI: 1063802205
Entity type: Organization
NPI issued: 26 Jan 2015
Record last updated: 26 Jan 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.