MEDICARE: LIGHTHOUSE HOMECARE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		MA

General Provider Information

NPI Number	:	1336566959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIGHTHOUSE HOMECARE SERVICES

Provider Business Mailing Address
First Line	:	49 PRINCE ST
Second Line	:
City	:	MILTON
State	:	MA
Zip	:	02186-2664
Country	:	US
Telephone Number	:	617-763-2766
Fax Number	:	617-273-1323

Provider Business Practice Location Address
First Line	:	49 PRINCE ST
Second Line	:
City	:	MILTON
State	:	MA
Zip	:	02186-2664
Country	:	US
Telephone Number	:	617-763-2766
Fax Number	:	617-273-1323

Authorized Official
Title or Position	:	CEO
Name	:	HOWARD YEE
Credential	:
Telephone Number	:	617-763-2766

Provider Enumeration Date	:	03/20/2014
Last Update Date	:	03/20/2014

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Directions to “LIGHTHOUSE HOMECARE SERVICES ” Practice Location

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