14D2097720 CLIA NUMBER - CANDLELIGHT HOME HEALTHCARE LLC

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Laboratory Demographics

CLIA Number: 14D2097720

Facility Name: CANDLELIGHT HOME HEALTHCARE LLC

Facility Address:
115 S BROADWAY ST
COAL CITY, IL
ZIP 60416
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Facility Phone Number: (815) 518-5165

Facility Type: HOME HEALTH AGENCY

Certificate Type: Waiver

NPI Number: 1972914372

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name	Field Value
CLIA Number	14D2097720
LAB Type	HOME HEALTH AGENCY
Facility Name	CANDLELIGHT HOME HEALTHCARE LLC
Street	115 S BROADWAY ST
City	COAL CITY
State	IL
ZIP	60416
Phone	(815) 518-5165

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This page was last updated on: 5/11/2023