Organization
LIGHTHOUSE YOUTH SERVICES INC. - AOD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THAD PARKER (VICE PRESDIENT BUSINESS MANAGER)
(513) 487-7137
Entity
Organization
Contact information
Practice address
401 E MCMILLAN ST, CINCINNATI, OH 45206-1922
(513) 221-3350
Mailing address
401 E MCMILLAN ST, CINCINNATI, OH 45206-1922
(513) 221-3350
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10128
—
OH
05
—
2847325
—
OH
Enumeration date
05/01/2012
Last updated
04/07/2025
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