Light House Group

NPI 1225166069 - Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X

NPI Details
NPI 1225166069
Enumeration Date 03/02/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CHARLES CHARLES
Position PRESIDENT
Phone (910) 497-0299
Fax (910) 497-0297
Practice Location
206 WAPITI DR
108 ASHTON PL
SPRING LAKE NC, 28390-1530, US
Phone (910) 497-0299
Fax (910) 497-0297
Business Location
408 HARRELL ST
PO BOX 1089
SPRING LAKE NC, 28390-3607, US
Phone (910) 497-0299
Fax (910) 497-0297
Toxanomy
Taxonomy Code 322D00000X
License State North Carolina
License Number MHL -026-805
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According to our database, Light House Group NPI is 1225166069, taxonomy code is 322D00000X and license number is MHL -026-805, license state is located at North Carolina. Light House Group physically located at 206 Wapiti Dr, Spring Lake NC, 28390-1530. NPI Number 1033115704 has the healthcare provider type.

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1225166069 NPI number is provided on an as is basis without warranty of any kind. 1225166069 is maintained by the National Plan & Provider Enumeration System. The contents of Light House Group are for informational purposes only.