Provider Demographics
NPI:1821654641
Name:LITTLE LANTERN HOME HEALTH LLC
Entity Type:Organization
Organization Name:LITTLE LANTERN HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BIJU
Authorized Official - Middle Name:
Authorized Official - Last Name:LUKOSE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-630-0472
Mailing Address - Street 1:4541 N JOSEY LN STE 110
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4622
Mailing Address - Country:US
Mailing Address - Phone:469-788-8588
Mailing Address - Fax:469-788-7800
Practice Address - Street 1:4541 N JOSEY LN STE 110
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4622
Practice Address - Country:US
Practice Address - Phone:469-788-8588
Practice Address - Fax:469-788-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility