Healthcare Provider Details

I. General information

NPI: 1114832987
Provider Name (Legal Business Name): CULTIV
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 KINGS HWY E
FAIRFIELD CT
06825-4867
US

IV. Provider business mailing address

501 KINGS HWY E
FAIRFIELD CT
06825-4867
US

V. Phone/Fax

Practice location:
  • Phone: 888-514-0714
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY FIGUEIREDO
Title or Position: APPRENTICE
Credential:
Phone: 203-300-1455