Provider Demographics
NPI:1639050677
Name:HOUSE OF LIGHT HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:HOUSE OF LIGHT HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGAER
Authorized Official - Prefix:
Authorized Official - First Name:CHIMWEMWE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIGAMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-302-9385
Mailing Address - Street 1:3923 IRISH HILLS DR APT 2A
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-6537
Mailing Address - Country:US
Mailing Address - Phone:619-302-9385
Mailing Address - Fax:
Practice Address - Street 1:3923 IRISH HILLS DR APT 2A
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-6537
Practice Address - Country:US
Practice Address - Phone:619-302-9385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care