Healthcare Provider Details

I. General information

NPI: 1386570190
Provider Name (Legal Business Name): BKJ LIGHTHOUSE HEALING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 SW 28TH ST STE B
TOPEKA KS
66614-2302
US

IV. Provider business mailing address

5040 SW 28TH ST STE B
TOPEKA KS
66614-2302
US

V. Phone/Fax

Practice location:
  • Phone: 785-969-2843
  • Fax:
Mailing address:
  • Phone: 785-969-2843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BRIAN JONES
Title or Position: OWNER
Credential:
Phone: 785-969-2843