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General NPI Number Information
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NPI Number | 1265134423
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE VOCATIONAL SERVICES
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Dates
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Enumeration Date | 03/21/2023
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 144 ORLAN RD
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City | NEW HOLLAND
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State | PA
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Zip | 17557-9108
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Country | US
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Telephone | 717-354-0355
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Fax |
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Provider Business Mailing Address
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Address Line | 144 ORLAN RD
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City | NEW HOLLAND
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State | PA
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Zip | 17557-9108
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Country | US
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Telephone | 717-354-0355
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Fax |
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Authorized Official
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Title or Position | CFO/COO
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Name | RYAN ELLIS
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Credential |
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Telephone | 717-354-0355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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