Organization
THE NORTHERN LIGHTHOUSE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY FAULKNER (ADMINISTRATOR)
(207) 425-3880
Entity
Organization
Contact information
Practice address
14 MAIN ST, MARS HILL, ME 04758
(207) 425-8880
Mailing address
PO BOX 498, MARS HILL, ME 04758-0498
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/17/2009
Last updated
11/17/2009
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