Organization
CULTIVATING FAMILY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KESHA GREEN LMFT, LICSW (DIRECTOR)
(763) 355-5461
Entity
Organization
Contact information
Practice address
3300 COUNTY ROAD 10, SUITE 304I, BROOKLYN CENTER, MN 55429-3072
(763) 355-5461
(763) 355-5692
Mailing address
3300 COUNTY ROAD 10 STE 304I, BROOKLYN CENTER, MN 55429-3066
(763) 355-5461
(763) 355-5692
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
25186
MN
106H00000X
Marriage & Family Therapist
3003
MN
251S00000X
Community/Behavioral Health Agency
3003, 25186
MN
Other
Enumeration date
12/05/2016
Last updated
02/08/2017
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