| Lighthouse | |
|
3250 E 40th St Room B Yuma AZ 85365-7994 | |
| (928) 341-4220 | |
| Not Available |
| Full Name | Lighthouse |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
| Location | 3250 E 40th St, Yuma, Arizona |
| Authorized Official Name and Position | John F Hogeboom (PRESIDENT/CEO) |
| Authorized Official Contact | 4808317566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse 1855 W. Baseline Rd. Suite 101 Mesa AZ 85202-9098 Ph: (480) 831-7566 | Lighthouse 3250 E 40th St Room B Yuma AZ 85365-7994 Ph: (928) 341-4220 |
| NPI Number | 1861722175 |
|---|---|
| Provider Enumeration Date | 01/08/2010 |
| Last Update Date | 01/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861722175 | NPI | - | NPPES |
| 488183 | Medicaid | AZ | |
| Z148077 | Other | AZ | MEDICARE PTAN |
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