Provider Demographics
NPI:1316534985
Name:LIGHTHOUSE FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:LIGHTHOUSE FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JO
Authorized Official - Last Name:BOWHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-435-2229
Mailing Address - Street 1:PO BOX 1208
Mailing Address - Street 2:
Mailing Address - City:KILMARNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22482-1208
Mailing Address - Country:US
Mailing Address - Phone:804-435-2229
Mailing Address - Fax:
Practice Address - Street 1:68 S MAIN ST
Practice Address - Street 2:
Practice Address - City:KILMARNOCK
Practice Address - State:VA
Practice Address - Zip Code:22482-9537
Practice Address - Country:US
Practice Address - Phone:804-435-2229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care