Provider Demographics
NPI:1790814440
Name:LITE HOUSE, INC.
Entity Type:Organization
Organization Name:LITE HOUSE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-355-5811
Mailing Address - Street 1:201 GOVERNMENT AVE SW
Mailing Address - Street 2:STE 304-A
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-2954
Mailing Address - Country:US
Mailing Address - Phone:828-355-5811
Mailing Address - Fax:800-688-0471
Practice Address - Street 1:201 GOVERNMENT AVE SW
Practice Address - Street 2:STE 304-A
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-2954
Practice Address - Country:US
Practice Address - Phone:828-355-5811
Practice Address - Fax:800-688-0471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health