Provider Demographics
NPI:1255065231
Name:LIGHTHOUSE BEACON CHURCH BEACON INSTITUTE
Entity type:Organization
Organization Name:LIGHTHOUSE BEACON CHURCH BEACON INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ TRUSTEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:F
Authorized Official - Last Name:SCHLERF
Authorized Official - Suffix:
Authorized Official - Credentials:MA CISM BA COUNSELIN
Authorized Official - Phone:804-384-9325
Mailing Address - Street 1:WARRIOR WAY WELLNESS CENTER
Mailing Address - Street 2:469 MCLAWS CIRCLE
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185
Mailing Address - Country:US
Mailing Address - Phone:804-384-9325
Mailing Address - Fax:804-201-4816
Practice Address - Street 1:WARRIOR WAY WELLNESS CENTER
Practice Address - Street 2:469 MCLAWS CIRCLE
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185
Practice Address - Country:US
Practice Address - Phone:804-384-9325
Practice Address - Fax:804-201-4816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-14
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health