NPI | 1225532849 |
---|---|
Doing Business As | CRADLESTONE, LLC |
Entity Type | Organization |
Authorized Contact | CHRISTOPHER JOHN WIEGENSTEIN CEO/Counselor 360-682-5519 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: WA 604194142) |
Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: WA 604194142) |
261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: WA 604194142) | |
Enumeration Date | 2018-03-20 |
Last Update Date | 2018-03-20 |