Provider Demographics
NPI:1558071712
Name:CULTIVATE JCF LLC
Entity Type:Organization
Organization Name:CULTIVATE JCF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAZI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-906-5620
Mailing Address - Street 1:820 OVERHILL CT
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3659
Mailing Address - Country:US
Mailing Address - Phone:404-906-5620
Mailing Address - Fax:
Practice Address - Street 1:3525 PIEDMONT ROAD
Practice Address - Street 2:BUILDING 7, SUITE 408
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305
Practice Address - Country:US
Practice Address - Phone:404-624-6740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty