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NPI Code Detail

MEDICARE: THE LIGHTHOUSE OF LOVE

MEDICARE: THE LIGHTHOUSE OF LOVE
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
1253Z00000XIn Home Supportive Care AgencyNV

General Provider Information

NPI Number : 1477900868
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE LIGHTHOUSE OF LOVE
Provider Business Mailing Address
First Line : 730 W CHEYENNE AVE
Second Line : SUITE 50
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7848
Country : US
Telephone Number : 702-258-0031
Fax Number : 702-221-0103
Provider Business Practice Location Address
First Line : 730 W CHEYENNE AVE
Second Line : SUITE 50
City : NORTH LAS VEGAS
State : NV
Zip : 89030-7848
Country : US
Telephone Number : 702-258-0031
Fax Number : 702-221-0103
Authorized Official
Title or Position : DIRECTOR
Name : MISS VICTORIA LASHAUN ANDERSON
Credential :
Telephone Number : 702-628-2887
Provider Enumeration Date : 05/16/2016
Last Update Date : 05/16/2016

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Directions to “THE LIGHTHOUSE OF LOVE ” 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.

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