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General NPI Number Information
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NPI Number | 1205749355
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Entity Type | Organization
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Legal Business Name | CANDIED KITCHEN LLC
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 3601 N 19TH ST
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City | WACO
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State | TX
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Zip | 76708-2001
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Country | US
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Telephone | 910-258-1734
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Fax |
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Provider Business Mailing Address
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Address Line | 3601 N 19TH ST
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City | WACO
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State | TX
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Zip | 76708-2001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | LAQUANDA BELL
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Credential |
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Telephone | 910-258-1734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State | NULL
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