| Lighthouse Autism Center | |
|
1827 E Ireland Rd South Bend IN 46614-2845 | |
| (574) 387-4313 | |
| (574) 204-2868 |
| Full Name | Lighthouse Autism Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1827 E Ireland Rd, South Bend, Indiana |
| Authorized Official Name and Position | Colin Dennis Sheridan (PRESIDENT) |
| Authorized Official Contact | 5743874313 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Autism Center 215 Red Coach Dr Mishawaka IN 46545-8307 Ph: (574) 387-4313 | Lighthouse Autism Center 1827 E Ireland Rd South Bend IN 46614-2845 Ph: (574) 387-4313 |
| NPI Number | 1942576905 |
|---|---|
| Provider Enumeration Date | 03/23/2012 |
| Last Update Date | 07/18/2024 |
| Certification Date | 07/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942576905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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