Provider Demographics
NPI:1801253430
Name:CANDLELIGHT HOME CARE
Entity type:Organization
Organization Name:CANDLELIGHT HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-725-5680
Mailing Address - Street 1:7224 CANDLELIGHT WAY
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-3711
Mailing Address - Country:US
Mailing Address - Phone:916-725-5680
Mailing Address - Fax:916-721-1157
Practice Address - Street 1:7224 CANDLELIGHT WAY
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-3711
Practice Address - Country:US
Practice Address - Phone:916-725-5680
Practice Address - Fax:916-721-1157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347000931311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility