Provider Demographics
NPI:1205682614
Name:CANDICE RAY OF HOPE CARE HOMES
Entity type:Organization
Organization Name:CANDICE RAY OF HOPE CARE HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:SASHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:307-216-0645
Mailing Address - Street 1:12715 CEDAR GROVE CT
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3091
Mailing Address - Country:US
Mailing Address - Phone:307-216-0645
Mailing Address - Fax:
Practice Address - Street 1:18915 ARMBULL CT
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2782
Practice Address - Country:US
Practice Address - Phone:281-318-1150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities