# LIGHT HOME CARE SERVICES LLC

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

## Provider details

- **NPI number:** 1760213193
- **Authorized official:** KHADIZA NKWENJE (CEO)
- **Authorized official phone:** (240) 660-8636

## Contact information

- **Practice address:** 7600 GEORGIA AVE NW STE 412D, WASHINGTON, DC 20012-1616
- **Practice address phone:** (240) 660-8636
- **Mailing address:** 7600 GEORGIA AVE NW STE 412D, WASHINGTON, DC 20012-1616

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | — |
| 251G00000X | Community Based Hospice Care Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | Yes |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QR0405X | Substance Use Disorder Rehabilitation Clinic/Center | — | NULL | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | — |
| 320800000X | Mental Illness Community Based Residential Treatment Facility | — | NULL | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |
| 372500000X | Chore Provider | — | NULL | — |
| 372500000X | Chore Provider | — | — | — |
| 372600000X | Adult Companion | — | NULL | — |
| 372600000X | Adult Companion | — | — | — |
| 376J00000X | Homemaker | — | NULL | — |
| 376J00000X | Homemaker | — | — | — |
| 385HR2055X | Child Mental Illness Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 08/08/2024
- **Last updated:** 08/08/2024