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Organization
LIGHTHORSE HEALTHCARE, INC.
Active
Organization
LIGHTHORSE HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLENE TAYLOR ED.D, LPC, CPCS, NCC (EXECUTIVE DIRECTOR)
(912) 882-3800
Entity
Organization
Contact information
Practice address
2060 DAN PROCTOR DR, SUITE 3300, SAINT MARYS, GA 31558-3894
(912) 882-3800
Mailing address
PO BOX 5250, SAINT MARYS, GA 31558-5250
(912) 882-3800
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174899454
NPI NUMBER
GA
Enumeration date
07/15/2014
Last updated
07/15/2014
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