# LIGHTHOUSE CLOVER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clover Rest Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558969105
- **Authorized official:** DOV LEBOVIC MSM LNHA (MEMBER)
- **Authorized official phone:** (516) 680-7687

## Contact information

- **Practice address:** 28 WASHINGTON ST, COLUMBIA, NJ 07832-2324
- **Practice address phone:** (908) 496-4307
- **Mailing address:** 180 HARBORVIEW N, LAWRENCE, NY 11559-1904
- **Mailing address phone:** (516) 680-7687

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/15/2020
- **Last updated:** 10/15/2020