Healthcare Provider Details

I. General information

NPI: 1891645693
Provider Name (Legal Business Name): LIGHTHOUSE HOME HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MONTGOMERY RD STE 165
ALTAMONTE SPRINGS FL
32714-6814
US

IV. Provider business mailing address

415 MONTGOMERY RD STE 165
ALTAMONTE SPRINGS FL
32714-6814
US

V. Phone/Fax

Practice location:
  • Phone: 407-617-6885
  • Fax:
Mailing address:
  • Phone: 407-617-6885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHELBY VALLEJO
Title or Position: PRESIDENT
Credential:
Phone: 407-617-6885