LIGHTHOUSE COMPLEX CARE OF DELAWARE INC NPI 1720797251

NPI Information

NPI: 1720797251
Provider Name: LIGHTHOUSE COMPLEX CARE OF DELAWARE INC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 08D2285740

Address:
2500 GRUBB RD STE 123
WILMINGTON, DE
ZIP 19810
Phone: (302) 304-3417
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LIGHTHOUSE COMPLEX CARE OF DELAWARE INC is a multi-specialty clinic center in Wilmington, DE. LIGHTHOUSE COMPLEX CARE OF DELAWARE INC NPI is 1720797251. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2500 GRUBB RD STE 123
WILMINGTON, DE
ZIP 19810-711
Phone: (302) 304-3417
Fax: (302) 467-2474

The provider's authorized official is Meera Manickam .
The authorized official title is Owner and has the following contact phone number (302) 740-1347.

The CLIA number assigned to this NPI record is 08D2285740 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/23/2022 and was last updated on 4/2/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	207Q00000X	Family Medicine		No
2	208000000X	Pediatrics		No
3	2084P0800X	Psychiatry & Neurology	Psychiatry	No
4	261QM1300X	Clinic/Center	Multi-Specialty	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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