Organization
LIGHTLE PSYCHIATRIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATTY KAY FRAY ARNP-BC (PSYCHIATRIC NURSE PRACTITIONER)
(509) 993-2021
Entity
Organization
Contact information
Practice address
13303 E MISSION AVE APT 189, SPOKANE VALLEY, WA 99216-2792
(509) 993-2021
Mailing address
13303 E MISSION AVE APT 189, SPOKANE VALLEY, WA 99216-2792
(509) 993-2021
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
AP60071357
WA
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
AP 60071357
WA
311ZA0620X
Adult Care Home Facility
AP 60071357
WA
314000000X
Skilled Nursing Facility
AP 60071357
WA
Other
Enumeration date
08/28/2010
Last updated
08/28/2010
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