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General NPI Number Information
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NPI Number | 1891049714
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE MINISTRIES, INC.
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Dates
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Enumeration Date | 10/30/2012
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 180 LIGHTHOUSE LN
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City | REEVES
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State | LA
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Zip | 70658-5941
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Country | US
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Telephone | 337-666-2678
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Fax | 337-666-2679
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | REEVES
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State | LA
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Zip | 70658-0130
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Country | US
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Telephone | 337-666-2678
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Fax | 337-666-2679
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. PATSY CAVENAH
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Credential |
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Telephone | 337-666-2678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number | 9145
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License Number State | LA
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