Organization
THE LIGHTHOUSE OF SOUTHERN MN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA STARKS (EXECUTIVE DIRECTOR)
(507) 456-2647
Entity
Organization
Contact information
Practice address
2797 SW 92ND AVE, MERIDEN, MN 56093-6211
(507) 475-9548
Mailing address
PO BOX 118, OWATONNA, MN 55060-0118
(507) 456-2647
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
Other
Enumeration date
06/12/2024
Last updated
01/07/2025
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