Organization
NORTHERN LIGHTHOUSE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT ALAN CRAY SR. (HUMAN RESOURCE ADMIN)
(207) 554-5114
Entity
Organization
Contact information
Practice address
14 MAIN ST, MARS HILL, ME 04758
(207) 425-3880
Mailing address
PO BOX 498, MARS HILL, ME 04758-0498
(207) 425-3880
(207) 425-9048
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
ME
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
ME
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135580000
—
ME
05
—
1355800001
—
ME
05
—
135580100
—
ME
05
—
432482300
—
ME
Enumeration date
05/02/2007
Last updated
02/04/2015
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