| Light House Recovery Services | |
|
921 2nd Ave S Fargo ND 58103-1705 | |
| (701) 361-9922 | |
| Not Available |
| Full Name | Light House Recovery Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 921 2nd Ave S, Fargo, North Dakota |
| Authorized Official Name and Position | Tara Gilbert (PEER SUPPORT ADMINISTRATOR) |
| Authorized Official Contact | 2187908445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Light House Recovery Services 921 2nd Ave S Fargo ND 58103-1705 Ph: () - | Light House Recovery Services 921 2nd Ave S Fargo ND 58103-1705 Ph: (701) 361-9922 |
| NPI Number | 1144920828 |
|---|---|
| Provider Enumeration Date | 03/09/2023 |
| Last Update Date | 03/09/2023 |
| Certification Date | 03/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144920828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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