Organization
THE LIGHT HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEMUKA HOSKINS HENDRIX (OWNER)
(336) 324-7223
Entity
Organization
Contact information
Practice address
116 YESTER OAKS WAY E APT J, GREENSBORO, NC 27455-3140
(336) 324-7223
Mailing address
116 YESTER OAKS WAY E APT J, GREENSBORO, NC 27455-3140
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/27/2024
Last updated
11/27/2024
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