Provider Demographics
NPI:1427500412
Name:HOME LIGHT SENIOR CARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:HOME LIGHT SENIOR CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:BLANCKE
Authorized Official - Suffix:SR
Authorized Official - Credentials:CSCM
Authorized Official - Phone:301-873-1547
Mailing Address - Street 1:2976 PENWICK LN
Mailing Address - Street 2:SUITE 104E
Mailing Address - City:DUNKIRK
Mailing Address - State:MD
Mailing Address - Zip Code:20754-9486
Mailing Address - Country:US
Mailing Address - Phone:301-873-1547
Mailing Address - Fax:
Practice Address - Street 1:2976 PENWICK LN
Practice Address - Street 2:SUITE 104E
Practice Address - City:DUNKIRK
Practice Address - State:MD
Practice Address - Zip Code:20754-9486
Practice Address - Country:US
Practice Address - Phone:301-873-1547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care