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Organization

LIGHTHOUSE OF JACKSON LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEN FLOWERS (MEMBER, CFO)
(517) 240-9329
Entity
Organization

Contact information

Practice address
228 E MAIN ST, SPRING ARBOR, MI 49283-9673
(517) 240-9329
Mailing address
2548 S SANDSTONE RD, JACKSON, MI 49201-9374
(517) 240-9329

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)

Other

Enumeration date
06/26/2021
Last updated
07/07/2021
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