Provider Demographics
NPI:1336566959
Name:LIGHTHOUSE HOMECARE SERVICES
Entity Type:Organization
Organization Name:LIGHTHOUSE HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-763-2766
Mailing Address - Street 1:49 PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:MA
Mailing Address - Zip Code:02186-2664
Mailing Address - Country:US
Mailing Address - Phone:617-763-2766
Mailing Address - Fax:617-273-1323
Practice Address - Street 1:49 PRINCE ST
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:MA
Practice Address - Zip Code:02186-2664
Practice Address - Country:US
Practice Address - Phone:617-763-2766
Practice Address - Fax:617-273-1323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health