Provider Demographics
NPI:1942635511
Name:GOOD CAWS LLC
Entity Type:Organization
Organization Name:GOOD CAWS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:603-396-9374
Mailing Address - Street 1:7130 SEMINOLE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-2254
Mailing Address - Country:US
Mailing Address - Phone:727-240-7488
Mailing Address - Fax:727-399-1715
Practice Address - Street 1:7130 SEMINOLE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-2254
Practice Address - Country:US
Practice Address - Phone:727-240-7488
Practice Address - Fax:727-399-1715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-13
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12239251S00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3085593Medicaid
NH3085593Medicaid