Organization
LIGHT CENTRAL HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL EDWARD BURNS (ALTERNATE ADMINISTRATOR)
(254) 413-0481
Entity
Organization
Contact information
Practice address
1505 W PEARL ST APT 11, GRANBURY, TX 76048-5224
(254) 413-0481
Mailing address
1505 W PEARL ST APT 11, GRANBURY, TX 76048-5224
(254) 413-0481
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
11/17/2017
Last updated
11/17/2017
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