Provider Demographics
NPI:1477900868
Name:THE LIGHTHOUSE OF LOVE
Entity Type:Organization
Organization Name:THE LIGHTHOUSE OF LOVE
Other - Org Name:WE CARE PERSONAL CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:LASHAUN
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-628-2887
Mailing Address - Street 1:730 W CHEYENNE AVE
Mailing Address - Street 2:SUITE 50
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-7848
Mailing Address - Country:US
Mailing Address - Phone:702-258-0031
Mailing Address - Fax:702-221-0103
Practice Address - Street 1:730 W CHEYENNE AVE
Practice Address - Street 2:SUITE 50
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7848
Practice Address - Country:US
Practice Address - Phone:702-258-0031
Practice Address - Fax:702-221-0103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care