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General NPI Number Information
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NPI Number | 1073534756
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE HEALTHCARE INC
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8394 G TERMINAL RD
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City | LORTON
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State | VA
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Zip | 22079
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Country | US
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Telephone | 703-550-1400
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Fax | 703-550-8860
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Provider Business Mailing Address
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Address Line | PO BOX 1043 8394 G TERMINAL RD
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City | NEWINGTON
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State | VA
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Zip | 22122-1043
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Country | US
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Telephone | 703-550-1400
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | WENDY SUTTON
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Credential |
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Telephone | 703-550-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 01120
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License Number State | VA
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