Organization
LIGHTHOUSE SUPPORT SERVICES, INC.
Active
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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