Organization
LIGHTHOUSE TRANSIT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENA C N AMANDA (MANAGER)
(763) 228-3023
Entity
Organization
Contact information
Practice address
1010 LAFOND AVE APT 4, SAINT PAUL, MN 55104-2115
(612) 564-0033
Mailing address
1605 CLIFF RD E APT 216, BURNSVILLE, MN 55337-1335
(763) 228-3023
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1079441100020
NON EMERGENCY MEDICAL TRANSPORTATION
MN
Enumeration date
04/08/2019
Last updated
04/08/2019
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