Organization
LIGHTHOUSE AFCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX BELLAMY (OWNER)
(850) 600-7082
Entity
Organization
Contact information
Practice address
739 EAST BLVD, CHIPLEY, FL 32428-2026
(850) 600-7082
Mailing address
739 EAST BLVD, CHIPLEY, FL 32428-2026
(850) 600-7082
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906928
FL
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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