Provider Demographics
NPI:1205862851
Name:CRADLE N' CRAYONS, LLC
Entity Type:Organization
Organization Name:CRADLE N' CRAYONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORELEI
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:808-927-5092
Mailing Address - Street 1:700 BISHOP ST STE 610
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4124
Mailing Address - Country:US
Mailing Address - Phone:808-927-5092
Mailing Address - Fax:808-694-3028
Practice Address - Street 1:700 BISHOP ST STE 610
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4124
Practice Address - Country:US
Practice Address - Phone:808-927-5092
Practice Address - Fax:808-694-3028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW19866930-01163WH0200X
251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI823527Medicaid
HI572588Medicaid