# JJDLIGHTCARE

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

## Provider details

- **NPI number:** 1841039898
- **Authorized official:** MRS. SIDONIE HEUMEN (NURSE PRACTITIONER)
- **Authorized official phone:** (443) 927-9694

## Contact information

- **Practice address:** 8719 TIMBER OAK LN, LAUREL, MD 20723-5919
- **Practice address phone:** (443) 927-9694
- **Practice address fax:** (443) 927-9694
- **Mailing address:** 7148 NATURES RD, COLUMBIA, MD 21046-1606
- **Mailing address phone:** (443) 927-9694
- **Mailing address fax:** (443) 927-9694

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | — | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/20/2024
- **Last updated:** 09/18/2026