Organization
LAUREL LIGHT LLC.
Active
Parent organization
LAUREL LIGHT LLC.
Other names
Laurel Healing Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
LAUREL LIGHT LLC.
Authorized official
MICHAEL RODGERS (CMO)
(267) 687-9008
Entity
Organization
Contact information
Practice address
801 BIRCHFIELD DR, MOUNT LAUREL, NJ 08054-4015
(703) 955-0587
Mailing address
801 BIRCHFIELD DR, MOUNT LAUREL, NJ 08054-4015
(703) 955-0587
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
03/10/2023
Last updated
03/10/2023
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