Provider Demographics
NPI:1205370137
Name:THE LIGHT TIME GIFT HEALTH CARE LLC
Entity Type:Organization
Organization Name:THE LIGHT TIME GIFT HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:UNUAGBON
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-876-1065
Mailing Address - Street 1:301 EDGEWATER PL
Mailing Address - Street 2:STE 100
Mailing Address - City:WAKEFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01880-1293
Mailing Address - Country:US
Mailing Address - Phone:978-876-1065
Mailing Address - Fax:
Practice Address - Street 1:301 EDGEWATER PL
Practice Address - Street 2:STE 100
Practice Address - City:WAKEFIELD
Practice Address - State:MA
Practice Address - Zip Code:01880-1293
Practice Address - Country:US
Practice Address - Phone:978-876-1065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency