Organization
PORCH LIGHT LLC
Active
Other names
na
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI CAMPBELL LCSW (THERAPIST)
(443) 449-9034
Entity
Organization
Contact information
Practice address
6263 W TWAIN AVE, LAS VEGAS, NV 89103-1153
(443) 449-9034
Mailing address
6263 W TWAIN AVE, LAS VEGAS, NV 89103-1153
(443) 449-9034
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
06/28/2020
Last updated
01/25/2021
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