Candy's House Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL12459 Issued in FL

Legal business name

CANDY'S HOUSE INC

Practice address

405 Rosedale Dr
Satellite Beach, FL 32937-3322

Phone

(321) 693-1776

NPI assigned

May 15, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kehinde EkwotafiaNPI 1881017077

Title

Administrator

Phone

(321) 693-1776

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kehinde Ekwotafia

  • Assisted Living Facility
  • Satellite Beach, FL
  • NPI 1881017077
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1851881833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 ROSEDALE DR",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329373322",
            "telephone_number": "321-693-1776",
            "fax_number": "321-610-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 ROSEDALE DR",
            "city": "SATELLITE BEACH",
            "state": "FL",
            "postal_code": "329373322",
            "telephone_number": "321-693-1776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDY'S HOUSE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "EKWOTAFIA",
        "authorized_official_first_name": "KEHINDE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "321-693-1776",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010756900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Burns
• C. Stevens Psychological Associates
• Ashleigh Calderon, LMT, CD, PCD
• Jonathan Trevino Calderon, DDS
• Kyle Callahan
• Frances Capraro, MD
• Careatc
• Maria De L. Carmona
• Jessica Nicole Carney, DC
• Caroliese Schmidt, MD PA

• Assisted Living Facility in Satellite Beach, FL
• Providers in Satellite Beach, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.