Organization
THE LIGHT CENTER RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHKEE FERGUSON MS, LICDC (CEO)
(330) 615-7355
Entity
Organization
Contact information
Practice address
718 GRAHAM RD, CUYAHOGA FALLS, OH 44221-1041
(330) 615-7355
(734) 758-0784
Mailing address
718 GRAHAM RD, CUYAHOGA FALLS, OH 44221-1041
(330) 615-7355
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02538
CAQH
—
05
—
0394224
—
OH
Enumeration date
02/24/2020
Last updated
02/13/2023
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