| Lighthouse Youth Services Inc. | |
|
131 N Ludlow St Suite 384 Dayton OH 45402-1116 | |
| (937) 586-0435 | |
| (937) 586-0441 |
| Full Name | Lighthouse Youth Services Inc. |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 131 N Ludlow St, Dayton, Ohio |
| Authorized Official Name and Position | Marilon Winther (VICE PRESIDENT, CFO) |
| Authorized Official Contact | 5132213350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Youth Services Inc. 1501 Madison Rd 2nd, Floor Cincinnati OH 45206-1776 Ph: (513) 221-3350 | Lighthouse Youth Services Inc. 131 N Ludlow St Suite 384 Dayton OH 45402-1116 Ph: (937) 586-0435 |
| NPI Number | 1063480846 |
|---|---|
| Provider Enumeration Date | 03/09/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063480846 | NPI | - | NPPES |
| 11166 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0259 (Ohio) | Primary |
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