Lighthouse Independent Living
NPI #1053548099 in Johnson City, Tennessee
Provider Information
- NPI Number
- 1053548099
- Entity Type
- Organization
- Organization Name
- Lighthouse Independent Living
- Primary Specialty
- Day Training, Developmentally Disabled Services
- Enumeration Date
- Jun 17, 2009
- Last Updated
- Jun 17, 2009
Practice Location
- Address
- 2882 BOONES CREEK RD
- City
- Johnson City
- State
- Tennessee
- ZIP Code
- 37615-4655
- Phone
- (423) 282-5555
Authorized Official
- Name
- MS. LISA RENEE BANNER
- Title
- DIRECTOR
- Phone
- (423) 282-5555
Specialties & Taxonomy Codes
| Specialty |
|---|
| Day Training, Developmentally Disabled Services |
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