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Organization

LIGHTHOUSE SITTING SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID CHANDLER R.N. (OWNER)
(770) 684-1284
Entity
Organization

Contact information

Practice address
40 PEACHTREE RD, ROCKMART, GA 30153-2812
(770) 684-1284
(770) 684-1284
Mailing address
40 PEACHTREE RD, ROCKMART, GA 30153-2812
(770) 684-1284
(770) 684-1284

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
115-R-0004
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
115-R-0004
HOME CARE LICENSE
GA
Enumeration date
06/20/2005
Last updated
08/22/2020
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