Organization
E.R.LIGHTHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN WEAVER (OWNER)
(757) 846-7229
Entity
Organization
Contact information
Practice address
846 W 35TH ST, NORFOLK, VA 23508-3011
(757) 961-4040
Mailing address
846 W 35TH ST, NORFOLK, VA 23508-3011
(757) 961-4040
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/01/2014
Last updated
10/01/2014
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