| The Lighthouse Behavior Health Center Llc | |
|
4099 Buckingham Pl Duluth GA 30096-4271 | |
| (404) 992-9538 | |
| Not Available |
| Full Name | The Lighthouse Behavior Health Center Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 4099 Buckingham Pl, Duluth, Georgia |
| Authorized Official Name and Position | Jenny Casteel (OWNER) |
| Authorized Official Contact | 4049929538 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Lighthouse Behavior Health Center Llc 4099 Buckingham Pl Duluth GA 30096-4271 Ph: () - | The Lighthouse Behavior Health Center Llc 4099 Buckingham Pl Duluth GA 30096-4271 Ph: (404) 992-9538 |
| NPI Number | 1891324588 |
|---|---|
| Provider Enumeration Date | 04/03/2020 |
| Last Update Date | 04/03/2020 |
| Certification Date | 04/03/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891324588 | NPI | - | NPPES |
| 1053892612 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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