| Lighthorse Inc | |
|
2060 Dan Proctor Drive Suite 3300 St Marys GA 31558 | |
| (912) 882-3800 | |
| (912) 882-3303 |
| Full Name | Lighthorse Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2060 Dan Proctor Drive, St Marys, Georgia |
| Authorized Official Name and Position | Carlene H Taylor (EXE DIRECTOR) |
| Authorized Official Contact | 9128823800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthorse Inc Po Box 5250 St Marys GA 31558 Ph: (912) 882-3800 | Lighthorse Inc 2060 Dan Proctor Drive Suite 3300 St Marys GA 31558 Ph: (912) 882-3800 |
| NPI Number | 1174899454 |
|---|---|
| Provider Enumeration Date | 03/30/2012 |
| Last Update Date | 11/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174899454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 251V00000X | Voluntary Or Charitable | (* (Not Available)) | Secondary |