Provider Demographics
NPI:1326506338
Name:LIGHTHOUSE HOME CARE LLC
Entity Type:Organization
Organization Name:LIGHTHOUSE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HENNIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:KARGBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-556-0243
Mailing Address - Street 1:962 MASTER DR
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:OH
Mailing Address - Zip Code:43119-8239
Mailing Address - Country:US
Mailing Address - Phone:614-556-0243
Mailing Address - Fax:
Practice Address - Street 1:962 MASTER DR
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:OH
Practice Address - Zip Code:43119-8239
Practice Address - Country:US
Practice Address - Phone:614-556-0243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health