Healthcare Provider Details

I. General information

NPI: 1841568086
Provider Name (Legal Business Name): CWM TRUST, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2011
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#6 GUALO RAI PLAZA, CHALAN PALE ARNOLD ROAD SUITE #6
SAIPAN MP
96950-0087
US

IV. Provider business mailing address

P.O. BOX 500087, CK
SAIPAN MP
96950-0087
US

V. Phone/Fax

Practice location:
  • Phone: 670-233-3647
  • Fax: 670-233-3647
Mailing address:
  • Phone: 670-233-3647
  • Fax: 670-233-3647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number0024
License Number StateMP

VIII. Authorized Official

Name: PAMELA CARHILL
Title or Position: CLINIC MANAGER
Credential:
Phone: 670-233-3647