Provider Demographics
NPI:1720843717
Name:LIGHTHOUSE BEGINNINGS
Entity Type:Organization
Organization Name:LIGHTHOUSE BEGINNINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ADKISSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPS
Authorized Official - Phone:612-670-8873
Mailing Address - Street 1:8055 INDUSTRIAL PARK RD
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-8269
Mailing Address - Country:US
Mailing Address - Phone:612-670-8873
Mailing Address - Fax:
Practice Address - Street 1:8055 INDUSTRIAL PARK RD
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-8269
Practice Address - Country:US
Practice Address - Phone:612-670-8873
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175T00000XOther Service ProvidersPeer SpecialistGroup - Single Specialty