Provider Demographics
NPI:1437812153
Name:LIGHTHOUSE KIDS LLC
Entity Type:Organization
Organization Name:LIGHTHOUSE KIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRANTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-497-6168
Mailing Address - Street 1:253 CORBIN PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4901
Mailing Address - Country:US
Mailing Address - Phone:917-497-6168
Mailing Address - Fax:
Practice Address - Street 1:253 CORBIN PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4901
Practice Address - Country:US
Practice Address - Phone:917-497-6168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management