Organization
LIGHTHOUSE HOSPICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH WILLIAM WEAVER JD, LCSW (CEO, ADMINISTRATOR)
(801) 562-2273
Entity
Organization
Contact information
Practice address
6794 S 1300 E, SALT LAKE CITY, UT 84121-2719
(801) 562-2273
Mailing address
6794 S. 1300 E., SALT LAKE CITY, UT 84121-2719
(801) 562-2273
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
V15693
UT
Other
Enumeration date
01/10/2007
Last updated
08/22/2020
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