Cultivating Connection Incorporated | |
1315 Franklin St Apt A Santa Monica CA 90404-2630 | |
(541) 517-6138 | |
Not Available |
Full Name | Cultivating Connection Incorporated |
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Speciality | Counselor |
Location | 1315 Franklin St Apt A, Santa Monica, California |
Authorized Official Name and Position | Thomas Peyton Kline (DIRECTOR) |
Authorized Official Contact | 5415176138 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Cultivating Connection Incorporated 1315 Franklin St Apt A Santa Monica CA 90404-2630 Ph: (541) 517-6138 | Cultivating Connection Incorporated 1315 Franklin St Apt A Santa Monica CA 90404-2630 Ph: (541) 517-6138 |
NPI Number | 1104681402 |
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Provider Enumeration Date | 02/15/2024 |
Last Update Date | 09/03/2024 |
Certification Date | 09/03/2024 |
Medicare PECOS PAC ID | 8628511573 |
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Medicare Enrollment ID | O20240619001782 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104681402 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Thomas Peyton Kline |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1508067562 PECOS PAC ID: 0446793392 Enrollment ID: I20240620002952 |
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