| Lighthouse Family Center, Ltd. | |
|
408 9th St Sw Ste 1610 Canton OH 44707-4714 | |
| (330) 305-2753 | |
| (330) 639-1712 |
| Full Name | Lighthouse Family Center, Ltd. |
|---|---|
| Speciality | Counselor |
| Location | 408 9th St Sw Ste 1610, Canton, Ohio |
| Authorized Official Name and Position | Aimee Thomas (OWNER) |
| Authorized Official Contact | 3303052753 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Family Center, Ltd. 6505 Rockside Rd Ste 105 Independence OH 44131-2386 Ph: (330) 697-7212 | Lighthouse Family Center, Ltd. 408 9th St Sw Ste 1610 Canton OH 44707-4714 Ph: (330) 305-2753 |
| NPI Number | 1043786882 |
|---|---|
| Provider Enumeration Date | 10/19/2018 |
| Last Update Date | 03/08/2019 |
| Medicare PECOS PAC ID | 1658813654 |
|---|---|
| Medicare Enrollment ID | O20240605003115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043786882 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
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