Organization
LIGHTHOUSE BEHAVIORAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD A GUTHRIE (PRESIDENT)
(405) 702-4435
Entity
Organization
Contact information
Practice address
1601 SW 89TH ST, SUITE E 200, OKLAHOMA CITY, OK 73159-6349
(405) 702-4435
(405) 702-4437
Mailing address
PO BOX 25016, OKLAHOMA CITY, OK 73125-0016
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
OK
251S00000X
Community/Behavioral Health Agency
Primary
—
OK
Other
Enumeration date
02/03/2015
Last updated
02/03/2015
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