Provider Demographics
NPI:1952671513
Name:CWM TRUST, LLC
Entity Type:Organization
Organization Name:CWM TRUST, LLC
Other - Org Name:EUCON HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR FOR SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:D
Authorized Official - Last Name:MIRAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:670-233-3647
Mailing Address - Street 1:PO BOX 500087
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-0087
Mailing Address - Country:US
Mailing Address - Phone:670-233-3647
Mailing Address - Fax:
Practice Address - Street 1:CHALAN PALE ARNOLD ROAD, GUALO RAI
Practice Address - Street 2:SUITE 6 GUALO RAI PLAZA
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-0087
Practice Address - Country:US
Practice Address - Phone:670-233-3647
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP20726-0002-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health