Provider Demographics
NPI:1508602640
Name:CEDAR VALLEY LLC
Entity type:Organization
Organization Name:CEDAR VALLEY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BUKOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALABEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-406-8008
Mailing Address - Street 1:4103 BAIRD LN
Mailing Address - Street 2:
Mailing Address - City:CRANDALL
Mailing Address - State:TX
Mailing Address - Zip Code:75114-0255
Mailing Address - Country:US
Mailing Address - Phone:929-406-8008
Mailing Address - Fax:
Practice Address - Street 1:4103 BAIRD LN
Practice Address - Street 2:
Practice Address - City:CRANDALL
Practice Address - State:TX
Practice Address - Zip Code:75114-0255
Practice Address - Country:US
Practice Address - Phone:929-406-8008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty