| Lighthouse Of Hope & Healing, Llc | |
|
1026 Northeast Dr Ste B Jefferson City MO 65109-2517 | |
| (573) 690-7919 | |
| (573) 636-7771 |
| Full Name | Lighthouse Of Hope & Healing, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1026 Northeast Dr Ste B, Jefferson City, Missouri |
| Authorized Official Name and Position | Christina L Sanni (OWNER) |
| Authorized Official Contact | 5736907919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Of Hope & Healing, Llc Po Box 105755 Jefferson City MO 65110-5755 Ph: (573) 690-7919 | Lighthouse Of Hope & Healing, Llc 1026 Northeast Dr Ste B Jefferson City MO 65109-2517 Ph: (573) 690-7919 |
| NPI Number | 1073135620 |
|---|---|
| Provider Enumeration Date | 05/16/2020 |
| Last Update Date | 05/16/2020 |
| Certification Date | 05/16/2020 |
| Medicare PECOS PAC ID | 4981053758 |
|---|---|
| Medicare Enrollment ID | O20231206001397 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073135620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Christina Louise Sanni |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063949659 PECOS PAC ID: 4880043660 Enrollment ID: I20231206001614 |
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