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General NPI Number Information
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NPI Number | 1942166020
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE PEDIATRIC THERAPY
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Dates
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Enumeration Date | 01/01/2026
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Last Update Date | 01/01/2026
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Provider Practice Location Address
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Address Line | 11174 E 13 MILE RD
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City | WARREN
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State | MI
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Zip | 48093-2559
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Country | US
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Telephone | 313-444-5038
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Fax |
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Provider Business Mailing Address
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Address Line | 11174 E 13 MILE RD
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City | WARREN
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State | MI
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Zip | 48093-2559
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Country | US
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Telephone | 313-444-5038
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALLYSON DOLL ANDREWS
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Credential | MSW
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Telephone | 313-888-1444
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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 |
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