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Organization

CULTIVATING CHANGE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DUWANDA S CONWAY (ORGAINZER/MEMBER)
(252) 458-1783
Entity
Organization

Contact information

Practice address
2109 SAINT ANDREW ST, STE 18, TARBORO, NC 27886-2149
(252) 458-1783
Mailing address
3530 S PITT ST, FARMVILLE, NC 27828-1884
(252) 458-1783

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
251B00000X
Case Management Agency
Primary
NC
251S00000X
Community/Behavioral Health Agency
NC

Other

Enumeration date
08/12/2008
Last updated
07/13/2010
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