Provider Demographics
NPI:1609513449
Name:LIGHTHOUSE KIDS FRANKLIN, LLC
Entity Type:Organization
Organization Name:LIGHTHOUSE KIDS FRANKLIN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-974-5239
Mailing Address - Street 1:7209 HALEY INDUSTRIAL DR STE 220
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-9672
Mailing Address - Country:US
Mailing Address - Phone:615-376-4863
Mailing Address - Fax:
Practice Address - Street 1:5030 CAROTHERS PKWY STE 120
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6029
Practice Address - Country:US
Practice Address - Phone:615-376-4863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services