Provider Demographics
NPI:1154139004
Name:LIGHTHOUSE HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:LIGHTHOUSE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HERVE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUHEMBURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-400-2376
Mailing Address - Street 1:333 SACO RD
Mailing Address - Street 2:
Mailing Address - City:HOLLIS CENTER
Mailing Address - State:ME
Mailing Address - Zip Code:04042-3415
Mailing Address - Country:US
Mailing Address - Phone:207-400-2376
Mailing Address - Fax:
Practice Address - Street 1:333 SACO RD
Practice Address - Street 2:
Practice Address - City:HOLLIS CENTER
Practice Address - State:ME
Practice Address - Zip Code:04042-3415
Practice Address - Country:US
Practice Address - Phone:207-400-2376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health