MEDICARE: CULTIVATE EDUCATION CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1679163646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CULTIVATE EDUCATION CORPORATION

Provider Business Mailing Address
First Line	:	1272 BOND ST STE 100
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-3084
Country	:	US
Telephone Number	:	512-772-4042
Fax Number	:

Provider Business Practice Location Address
First Line	:	2270 LA MONTANA WAY STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-6735
Country	:	US
Telephone Number	:	855-444-5664
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	JUSTIN STUMP
Credential	:
Telephone Number	:	855-444-5664

Provider Enumeration Date	:	01/22/2021
Last Update Date	:	04/29/2026

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