| Lighthouse Behavioral Wellness Centers | |
|
2425 W University Blvd Durant OK 74701-2970 | |
| (580) 924-7331 | |
| (580) 924-7332 |
| Full Name | Lighthouse Behavioral Wellness Centers |
|---|---|
| Speciality | Psychiatry & Neurology - Addiction Psychiatry |
| Location | 2425 W University Blvd, Durant, Oklahoma |
| Authorized Official Name and Position | Deana Tharp (DEPUTY EXECUTIVE DIRECTCOR) |
| Authorized Official Contact | 5803197305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Behavioral Wellness Centers 2425 W University Blvd-ste 100 Durant OK 74701-2970 Ph: () - | Lighthouse Behavioral Wellness Centers 2425 W University Blvd Durant OK 74701-2970 Ph: (580) 924-7331 |
| NPI Number | 1013542190 |
|---|---|
| Provider Enumeration Date | 03/09/2020 |
| Last Update Date | 05/20/2020 |
| Certification Date | 05/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013542190 | NPI | - | NPPES |
| 100728830 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0802X | Psychiatry & Neurology - Addiction Psychiatry | (* (Not Available)) | Primary |
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