Organization
LIGHTHOUSE BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY MICHELLE BERKOS LCSW (OWNER)
(847) 346-4566
Entity
Organization
Contact information
Practice address
215 S 4TH AVE, ST CHARLES, IL 60174-2913
(847) 347-4566
Mailing address
39W635 LORETTA DR, ST CHARLES, IL 60175-7613
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
149014342
IL
Other
Enumeration date
07/21/2011
Last updated
07/21/2011
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