Organization
LIGHTHOUSE ACADEMY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL BAILEY (OWNER)
(435) 851-6821
Entity
Organization
Contact information
Practice address
21260 N. 1450 E., MORONI, UT 84646-0383
(435) 851-6821
Mailing address
21260 NORTH 1450 EAST, MORONI, UT 84646
(435) 851-6821
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
32253J00000X
UT
Other
Enumeration date
05/20/2010
Last updated
05/20/2010
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