Organization
CULTIVATING CHANGE
Active
Other names
Cultivating Change
Organization subpart
No
Provider details
NPI number
Authorized official
DELORA WALKER (EXECUTIVE DIRECTOR)
(410) 493-3372
Entity
Organization
Contact information
Practice address
2512 N. CHARLES STREET, 1ST FLOOR/B, BALTIMORE, MD 21218-4645
(410) 493-3372
Mailing address
2512 N. CHARLES STREET, 1ST FLOOR/B, BALTIMORE, MD 21218-4645
(410) 493-3372
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558019489
—
MD
Enumeration date
04/18/2022
Last updated
06/28/2022
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