Provider Demographics
NPI:1568259620
Name:ETERNAL LIGHT CARE SERVICES LLC
Entity type:Organization
Organization Name:ETERNAL LIGHT CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:DADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-295-5793
Mailing Address - Street 1:421 LOVE AVE
Mailing Address - Street 2:
Mailing Address - City:EIGHT MILE
Mailing Address - State:AL
Mailing Address - Zip Code:36613-2513
Mailing Address - Country:US
Mailing Address - Phone:251-295-5793
Mailing Address - Fax:251-295-5793
Practice Address - Street 1:421 LOVE AVE
Practice Address - Street 2:
Practice Address - City:EIGHT MILE
Practice Address - State:AL
Practice Address - Zip Code:36613-2513
Practice Address - Country:US
Practice Address - Phone:251-295-5793
Practice Address - Fax:251-295-5793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No251E00000XAgenciesHome Health