Provider Demographics
NPI:1821620758
Name:CRADDLES LLC
Entity Type:Organization
Organization Name:CRADDLES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAKIRAT
Authorized Official - Middle Name:OLABISI
Authorized Official - Last Name:AROWOROWON
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:443-857-7475
Mailing Address - Street 1:5310 OLD COURT RD STE 303
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-6202
Mailing Address - Country:US
Mailing Address - Phone:443-857-7985
Mailing Address - Fax:
Practice Address - Street 1:1319 WOODBRIDGE STATION WAY STE 102
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-3852
Practice Address - Country:US
Practice Address - Phone:443-857-7475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-09
Last Update Date:2020-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty