Provider Demographics
NPI:1982204699
Name:LIGHTHOUSE HOSPICE CARE LLC
Entity Type:Organization
Organization Name:LIGHTHOUSE HOSPICE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:VANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:331-472-4706
Mailing Address - Street 1:648 N RIVER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8968
Mailing Address - Country:US
Mailing Address - Phone:331-472-4706
Mailing Address - Fax:331-472-4707
Practice Address - Street 1:648 N RIVER RD STE 100
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8968
Practice Address - Country:US
Practice Address - Phone:331-472-4706
Practice Address - Fax:331-472-4707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based