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General NPI Number Information
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NPI Number | 1659951820
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Entity Type | Organization
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Legal Business Name | CRADLE OF LOVE
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 04/02/2022
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Provider Practice Location Address
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Address Line | 1680 SUBURBAN AVE
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City | SAINT PAUL
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State | MN
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Zip | 55106-6632
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Country | US
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Telephone | 612-357-3241
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Fax | 651-330-9400
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Provider Business Mailing Address
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Address Line | 1680 SUBURBAN AVE
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City | SAINT PAUL
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State | MN
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Zip | 55106-6632
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Country | US
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Telephone | 612-357-3241
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Fax | 651-330-9400
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Authorized Official
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Title or Position | OWNER
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Name | SHARMAINE MEADOWS
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Credential |
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Telephone | 612-357-3241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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