Lighthouse Village

NPI 1023148434 - Assisted Living Facility - 310400000X

NPI Details
NPI 1023148434
Enumeration Date 03/06/2007
Last Updated 06/25/2013
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JACKIE JACKIE
Position MANAGING PARTNER
Phone (910) 353-7111
Fax (910) 353-2799
Practice Location
182 VILLAGE DR
JACKSONVILLE NC, 28546-7238, US
Phone (910) 353-7111
Fax (910) 353-2799
Business Location
PO BOX 878
OAK RIDGE NC, 27310-0878, US
Phone (336) 643-0555
Fax (336) 643-0553
Toxanomy
Taxonomy Code 310400000X
License State North Carolina
License Number HAL-067-013
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According to our database, Lighthouse Village NPI is 1023148434, taxonomy code is 310400000X and license number is HAL-067-013, license state is located at North Carolina. Lighthouse Village physically located at 182 Village Dr, Jacksonville NC, 28546-7238. NPI Number 1033115704 has the healthcare provider type.

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1023148434 NPI number is provided on an as is basis without warranty of any kind. 1023148434 is maintained by the National Plan & Provider Enumeration System. The contents of Lighthouse Village are for informational purposes only.