Lighthouse Therapeutics | |
720 100 Yearparty Ct Ste 200 Longmont CO 80504-8591 | |
(720) 449-6676 | |
(303) 374-5224 |
Full Name | Lighthouse Therapeutics |
---|---|
Speciality | Behavior Analyst |
Location | 720 100 Yearparty Ct Ste 200, Longmont, Colorado |
Authorized Official Name and Position | Hui-chung Jacquelina King (DIRECTOR OF OPERATIONS) |
Authorized Official Contact | 7633188088 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lighthouse Therapeutics 720 100 Yearparty Ct Ste 200 Longmont CO 80504-8591 Ph: (720) 449-6676 | Lighthouse Therapeutics 720 100 Yearparty Ct Ste 200 Longmont CO 80504-8591 Ph: (720) 449-6676 |
NPI Number | 1477937522 |
---|---|
Provider Enumeration Date | 07/17/2015 |
Last Update Date | 08/15/2024 |
Certification Date | 08/15/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477937522 | NPI | - | NPPES |
9000153728 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | 1-09-5794 (Colorado) | Primary |
106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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