Provider Demographics
NPI:1366213621
Name:SOUTHERN LIGHTS CONSULTING, LLC
Entity type:Organization
Organization Name:SOUTHERN LIGHTS CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MSN RN
Authorized Official - Phone:910-644-3932
Mailing Address - Street 1:7706 CANYON OAK DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-6328
Mailing Address - Country:US
Mailing Address - Phone:910-644-3932
Mailing Address - Fax:
Practice Address - Street 1:121 S WILCOX ST STE A2
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1910
Practice Address - Country:US
Practice Address - Phone:910-644-3932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN LIGHT CONSULTING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-15
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health