| NPI | 1164822193 |
|---|---|
| Doing Business As | LIGHTHOUSE ADDICTION SERVICES |
| Entity Type | Organization |
| Authorized Contact | BARRY K WYRICK Chief Operating Officer 941-255-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 2008AD655206) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |