Organization
LIGHTHOUSE TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAER JOUDEH MD (MD)
(864) 288-2006
Entity
Organization
Contact information
Practice address
3919 S HIGHWAY 14, BLDG A, GREENVILLE, SC 29615-6138
(864) 288-2006
(864) 288-1678
Mailing address
3919 S HIGHWAY 14, BLDG A, GREENVILLE, SC 29615-6138
(864) 288-2006
(864) 288-1678
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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