Organization
LIGHTHOUSE SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOEMI MEDINA BA (OWNER)
(321) 443-5612
Entity
Organization
Contact information
Practice address
2914 BOATING BLVD, KISSIMMEE, FL 34746-4540
(321) 443-5612
Mailing address
2914 BOATING BLVD, KISSIMMEE, FL 34746-4540
(321) 443-5612
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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