MEDICARE: LIGHTHOUSE HOME HEALTH CARE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	30211217	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174786701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIGHTHOUSE HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	800 VIRGINIA AVE
Second Line	:	S38K
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-5829
Country	:	US
Telephone Number	:	772-466-9199
Fax Number	:	772-466-4776

Provider Business Practice Location Address
First Line	:	800 VIRGINIA AVE
Second Line	:	S38K
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-5829
Country	:	US
Telephone Number	:	772-466-9199
Fax Number	:	772-466-4776

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. CHRYSTAL LYNN BAKER
Credential	:
Telephone Number	:	772-466-9199

Provider Enumeration Date	:	07/03/2008
Last Update Date	:	07/03/2008

Similar Medicare Providers

1821034919 — DR. GLORIA ELAINE MCNEIL M.D.
Practice Location Address:

800 VIRGINIA AVE STE 14
FORT PIERCE, FL
34982-5829

Practice Phone: 772-460-9811
Practice Fax: 772-210-1069

1881848190 — MUA ASSOCIATES, L.L.C.
Practice Location Address:

800 VIRGINIA AVE , SUITE 54
FORT PIERCE, FL
34982-5829

Practice Phone: 772-466-9820
Practice Fax: 772-466-9475

1326358516 — GONCAN INC
Practice Location Address:

800 VIRGINIA AVE , SUITE #33
FORT PIERCE, FL
34982-5829

Practice Phone: 772-882-4785
Practice Fax: 772-519-9982

1326479593 — MELISSA KINDER
Practice Location Address:

800 VIRGINIA AVE STE 14
FORT PIERCE, FL
34982-5829

Practice Phone: 772-464-3303
Practice Fax:

1457772063 — JENNIFER FETZER OTR/L
Practice Location Address:

800 VIRGINIA AVE STE 14
FORT PIERCE, FL
34982-5829

Practice Phone: 772-464-3303
Practice Fax:

1922475383 — BRIANNA NIQUETTE D.P.T.
Practice Location Address:

800 VIRGINIA AVE STE 148
FORT PIERCE, FL
34982-5829

Practice Phone: 772-464-6424
Practice Fax: 724-644-3247

Directions to “LIGHTHOUSE HOME HEALTH CARE, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.