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General NPI Number Information
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NPI Number | 1922332360
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Entity Type | Organization
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Legal Business Name | LIGHTHOUSE SCHOOL, INC.
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 10/01/2009
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Provider Practice Location Address
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Address Line | 25 WELLMAN AVENUE
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City | NORTH CHELMSFORD
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State | MA
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Zip | 01824-1334
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Country | US
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Telephone | 978-251-4050
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Fax | 978-513-2022
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Provider Business Mailing Address
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Address Line | 25 WELLMAN AVE
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City | NORTH CHELMSFORD
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State | MA
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Zip | 01863-1334
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Country | US
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Telephone | 978-251-4050
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Fax | 978-513-2022
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | MR. ROBERT BURNS
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Credential |
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Telephone | 978-251-4050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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