Provider Demographics
NPI:1912797606
Name:LIGHTHOUSE INTEGRATED CARE LLC
Entity type:Organization
Organization Name:LIGHTHOUSE INTEGRATED CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-210-0878
Mailing Address - Street 1:6505 E 82ND ST STE 109
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-0030
Mailing Address - Country:US
Mailing Address - Phone:317-210-0878
Mailing Address - Fax:317-219-0895
Practice Address - Street 1:6505 E 82ND ST STE 109
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-0030
Practice Address - Country:US
Practice Address - Phone:317-210-0878
Practice Address - Fax:317-219-0895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health