Organization
THE LIGHT HOUSE-GIFT OF LIFE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONJA HALL MAHONEY (FOUNDER EXECUTIVE DIRECTOR)
(301) 690-2029
Entity
Organization
Contact information
Practice address
203 CENTENNIAL STREET, SUITE 101, LA PLATA, MD 20646
(301) 934-3683
(301) 934-3785
Mailing address
PO BOX 157, NEWBURG, MD 20664-0157
(301) 934-3683
(301) 934-3785
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
LP33111
MD
Other
Enumeration date
12/23/2011
Last updated
03/09/2012
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