| The Lighthouse Therapy Center Llc | |
|
302 S 3rd St Greenville IL 62246-1733 | |
| (618) 699-5099 | |
| (618) 493-4178 |
| Full Name | The Lighthouse Therapy Center Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 302 S 3rd St, Greenville, Illinois |
| Authorized Official Name and Position | Mikaella Mari Walker (OWNER) |
| Authorized Official Contact | 6182927797 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Lighthouse Therapy Center Llc 302 S 3rd St Greenville IL 62246-1733 Ph: (618) 699-5099 | The Lighthouse Therapy Center Llc 302 S 3rd St Greenville IL 62246-1733 Ph: (618) 699-5099 |
| NPI Number | 1659070738 |
|---|---|
| Provider Enumeration Date | 02/28/2023 |
| Last Update Date | 03/01/2023 |
| Certification Date | 03/01/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659070738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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