Organization

Roots Seeds And Branches

Clinical Social Worker in Decatur, GA(View on Map)

Legal Business Name

Roots Seeds And Branches

NPI Number

1508353210

NPI Type

Organization

Enumeration Date

04/18/2018

Specialties

(Taxonomies)

Code

1041C0700X

Primary Taxonomy

Yes

Licenses

State

Georgia

License Number

CSW005018

Contact
Information

Purpose

Mailing
Location

Address

209A SWANTON WAY STE 202
209A SWANTON WAY STE 202

City

Decatur
Decatur

State

GA
GA

Postal Code

30030-3271
30030-3271

Country

US
US

Telephone Number

(404) 698-5553
(404) 698-5553

Authorized Official

Name

Mr. Julius Jessup Peterson

Title or Position

OWNER

Telephone Number

(404) 698-5553

Identifiers

Identifier

003181948C

Identifier State

GA

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 04/18/2018

Provider Address

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