Organization
CANDLELIGHT IN- HOME COMPANION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CRYSTAL LYNN GUY (OWNER)
(563) 391-8117
Entity
Organization
Contact information
Practice address
3901 MARQUETTE ST STE 1G, DAVENPORT, IA 52806-4440
(563) 391-8117
(563) 391-0615
Mailing address
3901 MARQUETTE ST STE 1G, DAVENPORT, IA 52806-4440
(563) 391-8117
(563) 391-0615
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
X000400375
—
IA
Enumeration date
11/19/2008
Last updated
11/19/2008
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