Organization
LIGHT HOUSE GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF PRESUTTI (CEO)
(480) 332-0385
Entity
Organization
Contact information
Practice address
108 E 2ND AVE, MESA, AZ 85210-1410
(480) 332-0385
Mailing address
9713 E EL PASO ST, MESA, AZ 85207-5351
(480) 332-0385
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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