Provider Demographics
NPI:1366955494
Name:LIGHTS OF HOME HEALTH CARE
Entity type:Organization
Organization Name:LIGHTS OF HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-406-1490
Mailing Address - Street 1:197 MOUND ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-4933
Mailing Address - Country:US
Mailing Address - Phone:740-406-0416
Mailing Address - Fax:
Practice Address - Street 1:197 MOUND ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-4933
Practice Address - Country:US
Practice Address - Phone:740-406-0416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-11
Last Update Date:2017-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health