Provider Demographics
NPI:1275053316
Name:CANDLELIGHT COMPASSIONS LLC
Entity Type:Organization
Organization Name:CANDLELIGHT COMPASSIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCILLE
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:ANKUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-655-0503
Mailing Address - Street 1:PO BOX 1211
Mailing Address - Street 2:
Mailing Address - City:ATMORE
Mailing Address - State:AL
Mailing Address - Zip Code:36504-1211
Mailing Address - Country:US
Mailing Address - Phone:251-975-0075
Mailing Address - Fax:251-975-0076
Practice Address - Street 1:2400 S US HIGHWAY 31
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-8227
Practice Address - Country:US
Practice Address - Phone:251-975-0075
Practice Address - Fax:251-975-0076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care