Organization
LIGHTHOUSE FOSTER CARE, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH TAMSAMOA AHQUIN SR. (EXECUTIVE DIRECTOR)
(435) 229-4889
Entity
Organization
Contact information
Practice address
50 E 100 S, SUITE #204, ST GEORGE, UT 84770-2318
(435) 229-4889
(877) 628-3606
Mailing address
50 E 100 S, SUITE #204, ST GEORGE, UT 84770-2318
(435) 229-4889
(877) 628-3606
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
17321
UT
261QM0850X
Adult Mental Health Clinic/Center
17746
UT
261QM0855X
Adolescent and Children Mental Health Clinic/Center
17746
UT
Other
Enumeration date
03/29/2011
Last updated
03/29/2011
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