Provider Demographics
NPI:1588489744
Name:COTTON GUARDIANSHIP SERVICES LLC.
Entity type:Organization
Organization Name:COTTON GUARDIANSHIP SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:
Authorized Official - Last Name:COTTON
Authorized Official - Suffix:
Authorized Official - Credentials:CPGC
Authorized Official - Phone:360-459-8637
Mailing Address - Street 1:700 SLEATER-KINNEY RD SE
Mailing Address - Street 2:STE B#134
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503
Mailing Address - Country:US
Mailing Address - Phone:360-459-8637
Mailing Address - Fax:
Practice Address - Street 1:7146 71ST WAY NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98516-9189
Practice Address - Country:US
Practice Address - Phone:360-459-8637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management