Provider Demographics
NPI:1326618521
Name:CRUSE CONSULTING LLC
Entity Type:Organization
Organization Name:CRUSE CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINO
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUSE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:480-749-2392
Mailing Address - Street 1:14622 N 18TH DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-5162
Mailing Address - Country:US
Mailing Address - Phone:480-749-2392
Mailing Address - Fax:
Practice Address - Street 1:14622 N 18TH DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-5162
Practice Address - Country:US
Practice Address - Phone:480-749-2392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities