Organization
LIGHTHOUSE SUPPORTED LIVING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA KABA (OWNER)
(614) 800-7842
Entity
Organization
Contact information
Practice address
1735 PARKFORD LN, COLUMBUS, OH 43229-7086
(614) 800-7842
Mailing address
PO BOX 14399, COLUMBUS, OH 43214-0399
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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