Organization
LIGHTHOUSE FAMILY RESIDENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBENEZER OFORI MPH (CHIEF ADMINISTRATIVE OFFICER)
(480) 238-2909
Entity
Organization
Contact information
Practice address
17524 N ROSA DR, MARICOPA, AZ 85138-1840
(480) 238-2909
Mailing address
17524 N ROSA DR, MARICOPA, AZ 85138-1840
(480) 238-2909
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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