Organization · NPI-2

20lighter, LLC

Clinic/Center · Little Rock, AR

NPI number1922764604
StatusActive
Last updated in NPPESDec 27, 2021

Details

NPI
1922764604
Entity type
Organization (NPI-2)
Legal business name
20lighter, LLC
Organization subpart
No
Enumeration date
Nov 16, 2021
Certification date
Dec 27, 2021
Last updated
Dec 27, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes
261QH0100X Clinic/Center, Health Services––

Practice location

10201 W Markham St Ste 234
Little Rock, AR 72205-2128

Phone 307-287-1555

Mailing address

1903 S Greeley Hwy # 324
Cheyenne, WY 82007-3447

Authorized official

Jessica Barnes
Ceo
3072871555

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