Organization
LIGHTHOUSE RANCH FOR BOYS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL SMITH (PRESIDENT/DIRECTOR)
(985) 878-6560
Entity
Organization
Contact information
Practice address
51453 HWY 443, LORANGER, LA 70446
(985) 878-6560
(985) 878-9370
Mailing address
PO BOX 238, LORANGER, LA 70446-0238
(985) 878-6560
(985) 878-9370
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
15250
LA
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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