Provider Demographics
NPI:1548574692
Name:CRANFORD GROUP, LLC
Entity Type:Organization
Organization Name:CRANFORD GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROJECT/FACILITY DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAVETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LSW, CAC
Authorized Official - Phone:570-629-7081
Mailing Address - Street 1:RR 3 BOX 2457
Mailing Address - Street 2:
Mailing Address - City:EFFORT
Mailing Address - State:PA
Mailing Address - Zip Code:18330-9450
Mailing Address - Country:US
Mailing Address - Phone:570-629-7081
Mailing Address - Fax:570-629-7082
Practice Address - Street 1:RR 3 BOX 2457
Practice Address - Street 2:
Practice Address - City:EFFORT
Practice Address - State:PA
Practice Address - Zip Code:18330-9450
Practice Address - Country:US
Practice Address - Phone:570-629-7081
Practice Address - Fax:570-629-7082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-31
Last Update Date:2010-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW012506L251S00000X
PA4776251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health