Organization
THE LIGHTHOUSE AFC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIA DAVIS (ADMINISTRATOR)
(269) 348-6217
Entity
Organization
Contact information
Practice address
438 DREXEL PL, KALAMAZOO, MI 49007-3470
(269) 348-6217
Mailing address
437 DREXEL PL, KALAMAZOO, MI 49007-3402
(269) 348-6217
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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