Organization
LIGHTHOUSE RTC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRELL HUNINGER JR. (EXECUTIVE DIRECTOR)
(928) 257-2293
Entity
Organization
Contact information
Practice address
13708 E 50TH ST, YUMA, AZ 85367-8503
(928) 246-4664
Mailing address
964 W 34TH PL, YUMA, AZ 85365-4357
(928) 257-2293
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
3048
AZ
Other
Enumeration date
02/20/2008
Last updated
05/16/2008
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