Healthcare Provider Details

I. General information

NPI: 1205862851
Provider Name (Legal Business Name): CRADLE N' CRAYONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 BISHOP ST STE 610
HONOLULU HI
96813-4124
US

IV. Provider business mailing address

700 BISHOP ST STE 610
HONOLULU HI
96813-4124
US

V. Phone/Fax

Practice location:
  • Phone: 808-927-5092
  • Fax: 808-694-3028
Mailing address:
  • Phone: 808-927-5092
  • Fax: 808-694-3028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberW19866930-01
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LORELEI CROWDER
Title or Position: CLINICAL DIRECTOR
Credential: RN
Phone: 808-927-5092