Provider Demographics
NPI:1568971158
Name:CULTIVATE OHIO, LLC
Entity Type:Organization
Organization Name:CULTIVATE OHIO, LLC
Other - Org Name:ACCESSING ABILITIES, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:
Authorized Official - Last Name:CURLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-955-1099
Mailing Address - Street 1:12600 HILL COUNTRY BLVD STE R-100
Mailing Address - Street 2:
Mailing Address - City:BEE CAVE
Mailing Address - State:TX
Mailing Address - Zip Code:78738-6748
Mailing Address - Country:US
Mailing Address - Phone:512-772-4042
Mailing Address - Fax:512-842-7446
Practice Address - Street 1:5061 STANSBURY DR
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-1230
Practice Address - Country:US
Practice Address - Phone:216-469-8398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CULTIVATE BEHAVIORAL MANAGEMENT CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH190103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty