Doctor Name: | MRS. CANDIE DAVIS RICHARDSON |
NPI Number: | 1912344003 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPN |
License Number: | 6905367 |
Business Practice Address: | 1748 Iron Bridge Rd Havana, FL - 323335294 |
Business Phone Number: | 8505393865 |
Business Fax Number: | 8505390736 |
Mailing Address: | 1748 Iron Bridge Rd, HAVANA |
State: | FL |
Postal Code: | 323335294 |
Phone Number: | 8505393865 |
Fax Number: | 8505390736 |
NPI Enumeration Date: | 05/29/2013 |
NPI Last Update Date: | 05/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 311ZA0620X |
License Number: | 6905367 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Custodial Care Facility |
Taxonomy Specialization: | Adult Care Home |
Taxonomy Definition: | A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |