Provider Demographics
NPI:1437723053
Name:LIGHT WITHIN HOME HEALTH AGENCY LLC
Entity Type:Organization
Organization Name:LIGHT WITHIN HOME HEALTH AGENCY LLC
Other - Org Name:LIGHT WITHIN HOME HEALTH LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HODAN
Authorized Official - Middle Name:FARAH
Authorized Official - Last Name:RAGE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:206-861-3232
Mailing Address - Street 1:9921 S 228TH PL
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-2559
Mailing Address - Country:US
Mailing Address - Phone:612-978-2495
Mailing Address - Fax:
Practice Address - Street 1:9921 S 228TH PL
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-2559
Practice Address - Country:US
Practice Address - Phone:206-861-3232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-18
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health