| NPI | 1861722175 |
|---|---|
| Doing Business As | LIGHTHOUSE |
| Entity Type | Organization |
| Authorized Contact | JOHN F HOGEBOOM President/CEO 480-831-7566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: AZ BH-3480) |
| 291U00000X Clinical Medical Laboratory (Licence: AZ BH-3480) | |
| 323P00000X Psychiatric Residential Treatment Facility (Licence: AZ BH-3480) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: AZ BH-3480) | |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: AZ BH-3480) | |
| Enumeration Date | 2010-01-08 |
| Last Update Date | 2023-01-13 |