Provider Demographics
NPI:1891049714
Name:LIGHTHOUSE MINISTRIES, INC.
Entity Type:Organization
Organization Name:LIGHTHOUSE MINISTRIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVENAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-666-2678
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:REEVES
Mailing Address - State:LA
Mailing Address - Zip Code:70658-0130
Mailing Address - Country:US
Mailing Address - Phone:337-666-2678
Mailing Address - Fax:337-666-2679
Practice Address - Street 1:180 LIGHTHOUSE LN
Practice Address - Street 2:
Practice Address - City:REEVES
Practice Address - State:LA
Practice Address - Zip Code:70658-5941
Practice Address - Country:US
Practice Address - Phone:337-666-2678
Practice Address - Fax:337-666-2679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9145322D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children