Organization
LIGHTHOUSE GROUP HOMES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TANDY LEANNE FAULKNER (EXECUTIVE DIRECTOR)
(469) 845-6419
Entity
Organization
Contact information
Practice address
2109 QUAIL RUN APT B, MCKINNEY, TX 75071-1013
(469) 845-6419
Mailing address
2109 QUAIL RUN APT B, MCKINNEY, TX 75071-1013
(469) 845-6419
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/25/2020
Last updated
10/25/2020
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