Cultivate Behavioral Health and Education- Illinois

NPI #1467058404 in Worth, Illinois

Provider Information

NPI Number: 1467058404
Entity Type: Organization
Organization Name: Cultivate Behavioral Health and Education- Illinois
Primary Specialty: Behavior Analyst
Enumeration Date: Dec 6, 2020
Last Updated: Dec 6, 2020

Practice Location

Address: 11055 S NAGLE AVE APT 5
City: Worth
State: Illinois
ZIP Code: 60482-1655
Phone: (224) 703-0502

Authorized Official

Name: OZZIE HOLMGREN, M.ED., BCBA
Title: REGIONAL VICE PRESIDENT
Phone: (631) 804-4268

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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