Provider Demographics
NPI:1669808895
Name:CASCADE CORPORATION
Entity type:Organization
Organization Name:CASCADE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LNHA
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-465-7171
Mailing Address - Street 1:144 MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2141
Mailing Address - Country:US
Mailing Address - Phone:609-465-7171
Mailing Address - Fax:
Practice Address - Street 1:144 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2141
Practice Address - Country:US
Practice Address - Phone:609-465-7171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CASCADE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ208300261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3755100Medicaid