Organization
LIGHTHOUSE BEHAVIORAL HEALTH, LLC WITHDRAWAL MANAGEMENT SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERNON O HOLMES (CEO)
(202) 651-1857
Entity
Organization
Contact information
Practice address
1119 E MONUMENT ST, BALTIMORE, MD 21202-4119
(443) 705-5056
Mailing address
1119 E MONUMENT ST, BALTIMORE, MD 21202-4119
(443) 705-5056
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/15/2019
Last updated
03/15/2019
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