Organization
LIGHT HOUSE AMBULATORY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FLORENCE ADENIKE OLADOKUN RN, FNP (OWNER-ADMINISTRATOR)
(520) 421-8334
Entity
Organization
Contact information
Practice address
121 W FLORENCE BLVD, SUITE B, CASA GRANDE, AZ 85122-4089
(520) 423-8334
(520) 421-2877
Mailing address
121 W FLORENCE BLVD, SUITE B, CASA GRANDE, AZ 85122-4089
(520) 423-8334
(520) 421-2877
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
12/10/2010
Last updated
12/10/2010
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