Organization
LIGHT HOUSE FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CLAUDETTE WALKER-SIMON (OWNER)
(602) 237-4066
Entity
Organization
Contact information
Practice address
3910 W DARROW ST, PHOENIX, AZ 85041-6010
(602) 237-4066
(602) 237-4066
Mailing address
3910 W DARROW ST, PHOENIX, AZ 85041-6010
(602) 237-4066
(602) 237-4066
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
BH3417
AZ
Other
Enumeration date
10/16/2009
Last updated
10/16/2009
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