Organization
LIGHT HOUSE RECOVERY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA GILBERT (PEER SUPPORT ADMINISTRATOR)
(218) 790-8445
Entity
Organization
Contact information
Practice address
921 2ND AVE S, FARGO, ND 58103-1705
(701) 361-9922
Mailing address
921 2ND AVE S, FARGO, ND 58103-1705
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/09/2023
Last updated
03/09/2023
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