Organization
LIGHTHOUSE PROFESSIONAL CLINICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELISSA FAYE JACKSON PHD (PRESIDENT)
(205) 565-1694
Entity
Organization
Contact information
Practice address
2024 ARKANSAS VALLEY DR, STE 206, LITTLE ROCK, AR 72212-4166
(501) 246-7171
(501) 246-7171
Mailing address
2024 ARKANSAS VALLEY DR, STE 206, LITTLE ROCK, AR 72212-4166
(501) 246-7171
(501) 246-7171
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
12-19P
AR
Other
Enumeration date
12/02/2013
Last updated
05/02/2014
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