Organization
LIGHTHOUSE COMMUNITY SUPPORT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAESHA L PITTS CPC (OFFICE MANGER)
(302) 883-7787
Entity
Organization
Contact information
Practice address
600 W DIVISION ST UNIT B, DOVER, DE 19904-2702
(267) 815-4350
Mailing address
600 W DIVISION ST UNIT B, DOVER, DE 19904-2702
(267) 815-4350
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831481761
—
DE
Enumeration date
09/30/2024
Last updated
09/30/2024
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