Provider Demographics
NPI:1447013743
Name:LYTEHAUS
Entity type:Organization
Organization Name:LYTEHAUS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:
Authorized Official - First Name:ALECIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RANKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,PMHNP,APRN
Authorized Official - Phone:239-380-9220
Mailing Address - Street 1:28501 SOLEIL CIR UNIT 211
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-6385
Mailing Address - Country:US
Mailing Address - Phone:239-380-9220
Mailing Address - Fax:
Practice Address - Street 1:6991 E CAMELBACK RD STE D300
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2492
Practice Address - Country:US
Practice Address - Phone:949-244-8368
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty