Organization
LIGHTHOUSE SUPPORT SERVICES, INC.
Active
Other names
LIGHTHOUSE GROUP HOME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUBEN CANCEL (CEO)
(772) 344-4954
Entity
Organization
Contact information
Practice address
826 SE SWEETBAY AVE, PORT ST LUCIE, FL 34983-4647
(772) 344-4954
(772) 344-5875
Mailing address
826 SE SWEETBAY AVE, PORT ST LUCIE, FL 34983-4647
(772) 344-4954
(772) 344-5875
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
F001
FL
Other
Enumeration date
03/08/2006
Last updated
07/21/2022
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