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General NPI Number Information
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NPI Number | 1962021550
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Entity Type | Organization
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Legal Business Name | LIGHTHOUZ HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 04/13/2020
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Provider Practice Location Address
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Address Line | 6418 SEABURY WAY
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City | ORLANDO
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State | FL
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Zip | 32818-1750
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Country | US
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Telephone | 407-720-9682
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Fax |
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Provider Business Mailing Address
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Address Line | 6418 SEABURY WAY
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City | ORLANDO
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State | FL
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Zip | 32818-1750
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Country | US
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Telephone | 407-720-9682
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | SEQUOIA FONSECA
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Credential | LPN
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Telephone | 407-952-5471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care 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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #8
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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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