Organization
LIGHTHOUSE COUNSELING CENTER LLC
Active
Other names
Lighthouse Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EARNEST WALLACE (CEO)
(469) 297-0096
Entity
Organization
Contact information
Practice address
5201 SW WESTGATE DR STE 100, PORTLAND, OR 97221-2424
(469) 297-0096
Mailing address
5201 SW WESTGATE DR STE 100, PORTLAND, OR 97221-2424
(469) 297-0096
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/08/2023
Last updated
09/29/2023
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