Organization
LIGHTHOUSE CHILD & FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE ANN NYBAKKE-HANENBURG LICSW (OWNER)
(320) 237-6252
Entity
Organization
Contact information
Practice address
17641 55TH ST NE, FOLEY, MN 56329-9761
(320) 237-6252
Mailing address
17641 55TH ST NE, FOLEY, MN 56329-9761
(320) 237-6252
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
15603
MN
Other
Enumeration date
09/28/2007
Last updated
09/28/2007
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