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General NPI Number Information
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NPI Number | 1831491489
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Entity Type | Organization
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Legal Business Name | CRADLE LIVING INC
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 18 KESTREL CT
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City | HEATH
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State | TX
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Zip | 75032-2043
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Country | US
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Telephone | 214-675-4732
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Fax |
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Provider Business Mailing Address
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Address Line | 220 BUTTON STREET
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City | LITTLE ELM
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State | TX
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Zip | 75068
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Country | US
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Telephone | 817-501-9769
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | VICTOR ONWUMERE
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Credential | CPA
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Telephone | 713-208-0251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 758931
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License Number State | TX
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