Organization
LIGHTHOUSE OF HOPE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMETRIUS CRAYTON (EXECUTIVE DIRECTOR)
(704) 956-3062
Entity
Organization
Contact information
Practice address
1536 PONDELLA DR, CHARLOTTE, NC 28213-5974
(704) 956-3062
Mailing address
1100 S TRYON ST, CHARLOTTE, NC 28203-4239
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/15/2016
Last updated
09/15/2016
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