Provider Demographics
NPI:1043753015
Name:VANDENBERK LAM INC
Entity Type:Organization
Organization Name:VANDENBERK LAM INC
Other - Org Name:FIRSTLIGHT HOME CARE OF CARLSBAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PASCAL
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN DEN BERK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-997-5092
Mailing Address - Street 1:2888 LOKER AVE E
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-6682
Mailing Address - Country:US
Mailing Address - Phone:760-340-3663
Mailing Address - Fax:
Practice Address - Street 1:2888 LOKER AVE E
Practice Address - Street 2:SUITE 301
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92010-6682
Practice Address - Country:US
Practice Address - Phone:760-340-3663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care