Provider Demographics
NPI:1952996530
Name:CULTIVATE4EXCELLENCE INC
Entity Type:Organization
Organization Name:CULTIVATE4EXCELLENCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KAMISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:BSW, MNP
Authorized Official - Phone:304-982-9644
Mailing Address - Street 1:13375 ARBOR POINTE CIR APT 101
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-1141
Mailing Address - Country:US
Mailing Address - Phone:304-982-9644
Mailing Address - Fax:
Practice Address - Street 1:13375 ARBOR POINTE CIR APT 101
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-1141
Practice Address - Country:US
Practice Address - Phone:304-982-9644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-04
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty