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General NPI Number Information
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NPI Number | 1063399418
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Entity Type | Organization
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Legal Business Name | CANDIS ASSISTED LIVING
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 1619 HANOVER AVE NW
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City | ROANOKE
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State | VA
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Zip | 24017-4023
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Country | US
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Telephone | 540-343-8640
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Fax |
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Provider Business Mailing Address
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Address Line | 1619 HANOVER AVE NW
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City | ROANOKE
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State | VA
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Zip | 24017-4023
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Country | US
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Telephone | 540-343-8640
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | CHERYL TWINE
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Credential |
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Telephone | 540-314-6692
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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