# LIGHTHOUSE HOME HEALTH CARE INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073657169
- **Authorized official:** MRS. CHRYSTAL FASSOLD (ADMINISTRATOR)
- **Authorized official phone:** (772) 466-9199

## Contact information

- **Practice address:** 1805 S 25TH ST STE 1, FORT PIERCE, FL 34947-4752
- **Practice address phone:** (772) 466-9199
- **Mailing address:** 1805 S 25TH ST STE 1, FORT PIERCE, FL 34947-4752
- **Mailing address phone:** (772) 466-9199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | NR30211217 | FL | Yes |

## Other

- **Enumeration date:** 02/20/2007
- **Last updated:** 08/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 691195196 | — | FL |