Lighthouse Residential Home
NPI #1407483316 in North Chesterfield, Virginia
Provider Information
- NPI Number
- 1407483316
- Entity Type
- Organization
- Organization Name
- Lighthouse Residential Home
- Primary Specialty
- Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Mar 23, 2020
- Last Updated
- Apr 9, 2020
Practice Location
- Address
- 5219 SUMMERLEAF DR
- State
- Virginia
- ZIP Code
- 23234-2817
- Phone
- (804) 337-1403
Authorized Official
- Name
- ROBERT EARL OWENS JR.
- Title
- PRESIDENT
- Phone
- (804) 337-1403
Specialties & Taxonomy Codes
| Specialty |
|---|
| Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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