Provider Demographics
NPI:1194548248
Name:CANDICE CARENE INC
Entity type:Organization
Organization Name:CANDICE CARENE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-723-1188
Mailing Address - Street 1:5123 W 98TH ST # 1210
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55437-2040
Mailing Address - Country:US
Mailing Address - Phone:800-693-4919
Mailing Address - Fax:
Practice Address - Street 1:331 2ND AVE S STE 500A
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55401-5510
Practice Address - Country:US
Practice Address - Phone:800-693-4919
Practice Address - Fax:855-454-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No385H00000XRespite Care FacilityRespite Care