Organization
LIGHTHOUSE HOME HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANDRA CROMARTIE (DIRECTOR OF OPERATIONS)
(336) 760-1812
Entity
Organization
Contact information
Practice address
1381 OLD MILL CIR, SUITE 130, WINSTON SALEM, NC 27103-1400
(336) 760-1812
(336) 760-1727
Mailing address
1381 OLD MILL CIR, SUITE 130, WINSTON SALEM, NC 27103-1400
(336) 760-1812
(336) 760-1727
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HC3208
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6601433
—
NC
Enumeration date
01/24/2007
Last updated
08/22/2020
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