Organization
NORTHERN LIGHTHOUSE DBA NORTHERN LIGHTHOUSE DAY CENTER
Active
Parent organization
NORTHERN LIGHTHOUSE
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHERN LIGHTHOUSE
Authorized official
MARY JO METTLER (PROGRAM ADMINISTRATOR)
(907) 398-2939
Entity
Organization
Contact information
Practice address
136 E REDOUBT AVE, SOLDOTNA, AK 99669-8012
(907) 398-2939
Mailing address
PO BOX 609, SOLDOTNA, AK 99669-0609
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
NONE ISSED BY STATE
AK
Other
Enumeration date
12/29/2009
Last updated
12/29/2009
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