| Lighthouse Behavioral Wellness Centers | |
|
2530 S Commerce St Bldg C Ardmore OK 73401-5519 | |
| (580) 226-5048 | |
| (580) 226-3569 |
| Full Name | Lighthouse Behavioral Wellness Centers |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 2530 S Commerce St Bldg C, Ardmore, Oklahoma |
| Authorized Official Name and Position | Deana Tharp (DEPUTY EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5803197305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Behavioral Wellness Centers Po Box 189 Ardmore OK 73402-0189 Ph: (580) 223-5070 | Lighthouse Behavioral Wellness Centers 2530 S Commerce St Bldg C Ardmore OK 73401-5519 Ph: (580) 226-5048 |
| NPI Number | 1649796590 |
|---|---|
| Provider Enumeration Date | 08/22/2017 |
| Last Update Date | 05/20/2020 |
| Certification Date | 05/20/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649796590 | NPI | - | NPPES |
| 100728830 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | 4157 (Oklahoma) | Primary |
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