Provider Demographics
NPI:1518857788
Name:CULTIVATED CONSULTANTS
Entity type:Organization
Organization Name:CULTIVATED CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-220-7086
Mailing Address - Street 1:341 MERTLE DR NE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35810-1084
Mailing Address - Country:US
Mailing Address - Phone:216-220-7086
Mailing Address - Fax:216-220-7086
Practice Address - Street 1:341 MERTLE DR NE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35810-1084
Practice Address - Country:US
Practice Address - Phone:216-220-7086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier