| Cultivating Change | |
|
2512 N. Charles Street 1st Floor/b Baltimore MD 21218-4645 | |
| (410) 493-3372 | |
| Not Available |
| Full Name | Cultivating Change |
|---|---|
| Speciality | Clinic/center |
| Location | 2512 N. Charles Street, Baltimore, Maryland |
| Authorized Official Name and Position | Delora Walker (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4104933372 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cultivating Change 2512 N. Charles Street 1st Floor/b Baltimore MD 21218-4645 Ph: (410) 493-3372 | Cultivating Change 2512 N. Charles Street 1st Floor/b Baltimore MD 21218-4645 Ph: (410) 493-3372 |
| NPI Number | 1093458051 |
|---|---|
| Provider Enumeration Date | 04/18/2022 |
| Last Update Date | 06/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093458051 | NPI | - | NPPES |
| 1558019489 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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