Healthcare Provider Details

I. General information

NPI: 1992416739
Provider Name (Legal Business Name): AMERICAN LIGHT HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 06/28/2023
Certification Date: 06/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 DISTRICT AVE
BURLINGTON MA
01803-5069
US

IV. Provider business mailing address

4 RIVERHURST RD APT 440
BILLERICA MA
01821-6603
US

V. Phone/Fax

Practice location:
  • Phone: 508-444-8851
  • Fax: 508-657-8338
Mailing address:
  • Phone: 775-338-0442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. HENRY LUBEGA
Title or Position: FOUNDER/CEO
Credential:
Phone: 775-338-0442