| NPI | 1912294349 |
|---|---|
| Doing Business As | DBA JUSTIN'S LIGHTHOUSE RECOVERY SERVICES |
| Entity Type | Organization |
| Authorized Contact | WINSTON SPENCER LEWIS Executive Director 405-919-8781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2011-07-06 |