Organization
LIGHT HOUSE SOBER LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENN BOWER (EXECUTIVE DIRECTOR)
(419) 967-5676
Entity
Organization
Contact information
Practice address
100 JACKSON ST, PORT CLINTON, OH 43452-1024
(419) 967-9550
(800) 434-1959
Mailing address
100 JACKSON ST, PORT CLINTON, OH 43452-1024
(419) 967-9550
(800) 434-1959
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
04/02/2026
Last updated
04/02/2026
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