Organization
LIGHT HAVEN: A SECOND CHANCES COMPANY
Active
Organization
LIGHT HAVEN: A SECOND CHANCES COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN NIGHTINGALE (CHIEF ETHICS OFFICER)
(541) 305-3763
Entity
Organization
Contact information
Practice address
2517 W 8TH ST, MUNCIE, IN 47302-1633
(541) 305-3763
Mailing address
2111 KINGS HWY, MEDFORD, OR 97501-4486
(541) 305-3763
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251B00000X
Case Management Agency
Primary
—
—
251E00000X
Home Health Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QV0200X
VA Clinic/Center
—
—
282J00000X
Religious Nonmedical Health Care Institution
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Enumeration date
03/09/2026
Last updated
06/08/2026
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