MEDICARE: CRADLE OF LOVE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	291U00000X	Clinical Medical Laboratory
3	324500000X	Substance Abuse Rehabilitation Facility
4	343900000X	Non-emergency Medical Transport (VAN)
5	347C00000X	Private Vehicle
6	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1629929146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRADLE OF LOVE LLC

Provider Business Mailing Address
First Line	:	3040 E CACTUS RD STE A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-7196
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3040 E CACTUS RD STE A
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-7196
Country	:	US
Telephone Number	:	612-357-3241
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SHARMAINE MEADOWS
Credential	:
Telephone Number	:	612-357-3241

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “CRADLE OF LOVE LLC ” Practice Location

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