| Cultivating Family Services, Llc | |
|
3300 County Road 10 Suite 304i Brooklyn Center MN 55429-3072 | |
| (763) 355-5461 | |
| (763) 355-5692 |
| Full Name | Cultivating Family Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3300 County Road 10, Brooklyn Center, Minnesota |
| Authorized Official Name and Position | Kesha Green (DIRECTOR) |
| Authorized Official Contact | 7633555461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cultivating Family Services, Llc 3300 County Road 10 Ste 304i Brooklyn Center MN 55429-3066 Ph: (763) 355-5461 | Cultivating Family Services, Llc 3300 County Road 10 Suite 304i Brooklyn Center MN 55429-3072 Ph: (763) 355-5461 |
| NPI Number | 1578007969 |
|---|---|
| Provider Enumeration Date | 12/05/2016 |
| Last Update Date | 02/08/2017 |
| Medicare PECOS PAC ID | 1557768991 |
|---|---|
| Medicare Enrollment ID | O20210927003292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578007969 | NPI | - | NPPES |
| Provider Name | Kesha S Green |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871831727 PECOS PAC ID: 4981975653 Enrollment ID: I20170731001663 |
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