Lighthouse for Recovery, LLC

NPI #1013298058 in Pocatello, Idaho

Provider Information

NPI Number
1013298058
Entity Type
Organization
Organization Name
Lighthouse for Recovery, LLC
Primary Specialty
Counselor - Addiction (Substance Use Disorder)
Enumeration Date
Sep 5, 2011
Last Updated
Sep 5, 2011

Practice Location

Address
1135 YELLOWSTONE AVE
Address 2
SUITE D
State
Idaho
ZIP Code
83201-5082
Phone
(208) 232-2908

Authorized Official

Name
MR. WILLIAM C. SLAVEN, LCSW, CADC
Title
EXECUTIVE DIRECTOR
Phone
(208) 237-3365

Specialties & Taxonomy Codes

Specialty
Counselor - Addiction (Substance Use Disorder)Addiction (Substance Use Disorder)

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