Provider Demographics
NPI:1710426275
Name:FIRSTLIGHT HOMECARE LLC
Entity Type:Organization
Organization Name:FIRSTLIGHT HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HAMBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-294-4864
Mailing Address - Street 1:43218 BUSINESS PARK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-3601
Mailing Address - Country:US
Mailing Address - Phone:951-395-0821
Mailing Address - Fax:
Practice Address - Street 1:43218 BUSINESS PARK DR STE 101
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3601
Practice Address - Country:US
Practice Address - Phone:951-395-0821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care