Organization
LIGHTHOUSE FAMILY CARE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUNA DELI (OWNER)
(754) 273-3343
Entity
Organization
Contact information
Practice address
126 ANTLER RD, GREENVILLE, NC 27834-6854
(754) 273-3343
Mailing address
126 ANTLER RD, GREENVILLE, NC 27834-6854
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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