Provider Demographics
NPI:1447591144
Name:LIGHT HOMEMAKER AND COMPANION SERVICES LLC
Entity Type:Organization
Organization Name:LIGHT HOMEMAKER AND COMPANION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ODETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:CONSTANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-562-1331
Mailing Address - Street 1:801 INTERNATIONAL PKWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4762
Mailing Address - Country:US
Mailing Address - Phone:407-562-1331
Mailing Address - Fax:407-585-2041
Practice Address - Street 1:801 INTERNATIONAL PKWY
Practice Address - Street 2:SUITE 500
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4762
Practice Address - Country:US
Practice Address - Phone:407-562-1331
Practice Address - Fax:407-585-2041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL233619251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health