Light House Group
NPI #1225166069 in Spring Lake, North Carolina
Provider Information
- NPI Number
- 1225166069
- Entity Type
- Organization
- Organization Name
- Light House Group
- Primary Specialty
- Residential Treatment Facility, Emotionally Disturbed Children
- Enumeration Date
- Mar 2, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 206 WAPITI DR
- Address 2
- 108 ASHTON PL
- City
- Spring Lake
- State
- North Carolina
- ZIP Code
- 28390-1530
- Phone
- (910) 497-0299
Authorized Official
- Name
- CHARLES DAVENPORT
- Title
- PRESIDENT
- Phone
- (910) 497-0299
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Emotionally Disturbed Children |
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