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CEDARCREST BEHAVIORAL MEDICINE LLC

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Company Details

Legal Name: CEDARCREST BEHAVIORAL MEDICINE LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: December 6th 2024
Expiration date: 31 Dec 2025
UBI Number: 605 654 810
ZIP code: 99206
City: Spokane
County: SPOKANE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 10510 E 20TH AVE, SPOKANE VLY, WA, 99206-3305, UNITED STATES

Contact Details

E-Mail: PROVIDER@ANIFHOME.COM
Phone Number: +1 770-292-0854

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Registered Agent Information

Name Role Address
GEORGE WANGAI Registered Agent 10510 E 20TH AVE, SPOKANE VLY, WA, 99206-3305, UNITED STATES

Key Officers & Management

Name Role Address
GEORGE WANGAI Executor 14024 E CATALDO AVE, SPOKANE VLY, WA, 99216-3306, UNITED STATES
SALOME MUNYORI Executor 10510 E 20TH AVE, SPOKANE VLY, WA, 99206-3305, UNITED STATES

National Provider Identifier

NPI Number:
1700698271
Certification Date:
2025-02-05

Authorized Person:

Name:
GEORGE WANGAI
Role:
CO-OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
5097329970
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