Provider Demographics
NPI:1982315354
Name:LIGHT OF LIFE, INC.
Entity Type:Organization
Organization Name:LIGHT OF LIFE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GISELA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-568-8704
Mailing Address - Street 1:10967 LAKE UNDERHILL RD STE 112
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-4434
Mailing Address - Country:US
Mailing Address - Phone:407-568-8704
Mailing Address - Fax:407-674-6808
Practice Address - Street 1:10967 LAKE UNDERHILL RD STE 112
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4434
Practice Address - Country:US
Practice Address - Phone:407-568-8704
Practice Address - Fax:407-674-6808
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:299995555
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care