Provider Demographics
NPI:1689243578
Name:5CODYS LLC
Entity Type:Organization
Organization Name:5CODYS LLC
Other - Org Name:SKIPPING STONES BEHAVIORAL LEARNING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-601-2570
Mailing Address - Street 1:16821 SE MCGILLIVRAY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-0401
Mailing Address - Country:US
Mailing Address - Phone:360-818-9593
Mailing Address - Fax:360-828-1001
Practice Address - Street 1:16821 SE MCGILLIVRAY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-0401
Practice Address - Country:US
Practice Address - Phone:360-818-9593
Practice Address - Fax:360-828-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty