Organization
LIGHTHOUSE 1 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM WRIGHT (OWNER)
(804) 274-9068
Entity
Organization
Contact information
Practice address
3810 W HUNDRED RD, CHESTER, VA 23831-1930
(804) 318-1484
Mailing address
3810 W HUNDRED RD, CHESTER, VA 23831-1930
(804) 318-1484
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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