Provider Demographics
NPI:1568165249
Name:CANDESCENT HOME CARE
Entity Type:Organization
Organization Name:CANDESCENT HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAYTEE-ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUMAUIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-815-9266
Mailing Address - Street 1:12642 SUSAN LN
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92841-4951
Mailing Address - Country:US
Mailing Address - Phone:714-815-9266
Mailing Address - Fax:
Practice Address - Street 1:12642 SUSAN LN
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4951
Practice Address - Country:US
Practice Address - Phone:714-815-9266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility