Organization
LIGHTHOUSE BEHAVIORAL WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRESHA HAYES (CEO)
(214) 326-2288
Entity
Organization
Contact information
Practice address
1515 E KEARNEY ST STE 400, MESQUITE, TX 75149-2687
(214) 326-2288
Mailing address
1203 ANTOINETTE DR, PRINCETON, TX 75407-2829
(214) 326-2288
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
174400000X
Specialist
Primary
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/01/2024
Last updated
11/15/2024
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