# COTTON CANDY CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205640729
- **Authorized official:** AVA LYNN MURRAY CHAVARRIA RN (OWNER / ADMINISTRATOR)
- **Authorized official phone:** (229) 894-3505

## Contact information

- **Practice address:** 4833 MELVILLE AVE STE B, EAST CHICAGO, IN 46312-3555
- **Practice address phone:** (229) 894-3505
- **Mailing address:** 3455 PATEVILLE RD, CORDELE, GA 31015-8747
- **Mailing address phone:** (229) 894-3505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/04/2025
- **Last updated:** 02/04/2025