Organization
THE LIGHTHOUSE VOC-ED CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KASSIDY BROWN (EXECUTIVE DIRECTOR)
(860) 445-7626
Entity
Organization
Contact information
Practice address
125 SHAW ST, NEW LONDON, CT 06320-4900
(860) 445-7626
Mailing address
PO BOX 271, OLD MYSTIC, CT 06372-0271
(860) 448-4200
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
03/25/2022
Last updated
06/23/2022
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