Provider Demographics
NPI:1942084355
Name:LIGHT WAY LLC
Entity Type:Organization
Organization Name:LIGHT WAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:LOVE
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:908-448-2791
Mailing Address - Street 1:1611 BEAVER DAM ROAD
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT
Mailing Address - State:NJ
Mailing Address - Zip Code:08742
Mailing Address - Country:US
Mailing Address - Phone:908-448-2791
Mailing Address - Fax:
Practice Address - Street 1:1611 BEAVER DAM ROAD
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT
Practice Address - State:NJ
Practice Address - Zip Code:08742
Practice Address - Country:US
Practice Address - Phone:908-448-2791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care