Organization
LIGHTHOUSE CARE CENTER OF OCONEE
Active
Parent organization
LIGHTHOUSE CARE CENTER OF AUGUSTA
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIGHTHOUSE CARE CENTER OF AUGUSTA
Authorized official
DEBBY THEIS (CFO)
(706) 651-0005
Entity
Organization
Contact information
Practice address
391 WHITE ROCK RD, TAMASSEE, SC 29686-2015
(864) 944-9875
(706) 651-7666
Mailing address
3100 PERIMETER PKWY, AUGUSTA, GA 30909-4583
(706) 651-0005
(706) 651-7666
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
23245800006
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
885MXH
—
TN
Enumeration date
08/05/2008
Last updated
10/07/2008
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