# LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** C-URC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376360495
- **Authorized official:** DEANA THARP LPC (CHIEF CLINICAL COMPLIANCE OFFICER)
- **Authorized official phone:** (580) 319-7305

## Contact information

- **Practice address:** 2425 W UNIVERSITY BLVD STE 100, DURANT, OK 74701-2970
- **Practice address phone:** (580) 745-1188
- **Mailing address:** PO BOX 189, ARDMORE, OK 73402-0189
- **Mailing address phone:** (580) 319-7305
- **Mailing address fax:** (580) 319-7328

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/20/2024
- **Last updated:** 09/20/2024