Organization Name: | LIGHTHOUSE HOSPICE GROUP, LLC |
NPI Number: | 1295027159 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER GABRIEL (PRESIDENT/CO-OWNER) |
Mailing Address: | 110 Oak Park Dr Unit C Irmo |
State: | SC US |
Postal Code: | 290636110 |
Phone Number: | 8037811935 |
Fax Number: | 8037811936 |
NPI Enumeration Date: | 05/11/2011 |
NPI Last Update Date: | 05/11/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |