Provider Demographics
NPI:1831679414
Name:LIGHT THE WAY, INC
Entity Type:Organization
Organization Name:LIGHT THE WAY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:THISTLEWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-524-3653
Mailing Address - Street 1:306 W 8TH ST APT D
Mailing Address - Street 2:
Mailing Address - City:METROPOLIS
Mailing Address - State:IL
Mailing Address - Zip Code:62960-1656
Mailing Address - Country:US
Mailing Address - Phone:618-524-3653
Mailing Address - Fax:618-524-4769
Practice Address - Street 1:306 W 8TH ST APT D
Practice Address - Street 2:
Practice Address - City:METROPOLIS
Practice Address - State:IL
Practice Address - Zip Code:62960-1656
Practice Address - Country:US
Practice Address - Phone:618-524-3653
Practice Address - Fax:618-524-4769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)