# LP LIGHTHOUSE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295189173
- **Authorized official:** MR. LARRY D PRUITT (OWNER)
- **Authorized official phone:** (248) 234-8533

## Contact information

- **Practice address:** 25820 SOUTHFIELD RD STE 202, SOUTHFIELD, MI 48075-1828
- **Practice address phone:** (248) 234-8533
- **Practice address fax:** (248) 234-8533
- **Mailing address:** 25820 SOUTHFIELD RD STE 202, SOUTHFIELD, MI 48075-1828
- **Mailing address phone:** (248) 234-8533
- **Mailing address fax:** (248) 234-8533

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | MI | Yes |

## Other

- **Enumeration date:** 04/18/2016
- **Last updated:** 04/18/2016