Lighthouse Behavioral Wellness Centers | |
301 W 4th St Ada OK 74820-3411 | |
(580) 436-2690 | |
(580) 436-5539 |
Full Name | Lighthouse Behavioral Wellness Centers |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 301 W 4th St, Ada, Oklahoma |
Authorized Official Name and Position | Deana Tharp (DEPUTY EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5803197305 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Lighthouse Behavioral Wellness Centers Po Box 189 Ardmore OK 73402-0189 Ph: (580) 319-7305 | Lighthouse Behavioral Wellness Centers 301 W 4th St Ada OK 74820-3411 Ph: (580) 436-2690 |
NPI Number | 1033265764 |
---|---|
Provider Enumeration Date | 01/26/2007 |
Last Update Date | 05/20/2020 |
Certification Date | 05/20/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033265764 | NPI | - | NPPES |
100728830 K | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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