Organization
CASCADE CONNECTIONS
Active
Parent organization
CASCADE CONNECTIONS
Organization subpart
Yes
Provider details
NPI number
Legal business name
CASCADE CONNECTIONS
Authorized official
MR. GEORGE EDWARD BEANBLOSSOM JR. (EXECUTIVE DIRECTOR)
(360) 714-9355
Entity
Organization
Contact information
Practice address
1354 PACIFIC PLACE, SUITE 101, FERNDALE, WA 98248
(360) 714-9355
(360) 312-0332
Mailing address
P.O. BOX 3174, FERNDALE, WA 98248-3174
(360) 714-9355
(360) 312-0332
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1117241
PROVIDERONE ID
WA
Enumeration date
07/21/2020
Last updated
07/21/2020
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