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General NPI Number Information
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NPI Number | 1366810236
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE NURSING INC
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Dates
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Enumeration Date | 09/09/2015
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 328 ANTELOPE TRL
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City | KILLEEN
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State | TX
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Zip | 76542-5008
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Country | US
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Telephone | 254-368-6266
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Fax | 254-501-9206
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Provider Business Mailing Address
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Address Line | 328 ANTELOPE TRL
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City | KILLEEN
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State | TX
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Zip | 76542-5008
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Country | US
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Telephone | 254-368-6266
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Fax | 254-501-9206
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Authorized Official
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Title or Position | CEO
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Name | MR. BERT ISTRE
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Credential |
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Telephone | 254-368-7410
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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 |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | TX
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