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Organization

LIGHTHOUSE COUNSELING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CANDYCE L DEKRUYFF (EXECUTIVE DIRECTOR)
(334) 286-5980
Entity
Organization

Contact information

Practice address
1415 E SOUTH BLVD, MONTGOMERY, AL 36116-2319
(334) 286-5980
(334) 286-5993
Mailing address
1415 E SOUTH BLVD, MONTGOMERY, AL 36116-2319
(334) 286-5980
(334) 286-5993

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
330034061
AL
Enumeration date
09/22/2005
Last updated
07/02/2008
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