Provider Demographics
NPI:1851799779
Name:LIGHTHOUSE HEALTH, INC.
Entity Type:Organization
Organization Name:LIGHTHOUSE HEALTH, INC.
Other - Org Name:INTERIM HEALTHCARE OF PASADENA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GANNON
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-379-8005
Mailing Address - Street 1:140 S LAKE AVE
Mailing Address - Street 2:SUITE 254
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-4710
Mailing Address - Country:US
Mailing Address - Phone:626-219-6348
Mailing Address - Fax:626-219-6398
Practice Address - Street 1:140 S LAKE AVE
Practice Address - Street 2:SUITE 254
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-4710
Practice Address - Country:US
Practice Address - Phone:626-219-6348
Practice Address - Fax:626-219-6398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health