Organization
LIGHTHOUSE CHILD & FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE ANN HANENBURG 3209832335 (CLINICAL DIRECTOR/OWNER)
(320) 983-2335
Entity
Organization
Contact information
Practice address
160 3RD AVE NW, MILACA, MN 56353-1555
(320) 983-2335
Mailing address
160 3RD AVE NW, MILACA, MN 56353-1555
(320) 983-2335
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1689861197
MN
Other
Enumeration date
06/18/2013
Last updated
06/18/2013
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