Lighthouse Behavioral Wellness Centers | |
2425 W University Blvd Ste 102 Durant OK 74701-2970 | |
(580) 924-7330 | |
(580) 924-7334 |
Full Name | Lighthouse Behavioral Wellness Centers |
---|---|
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 2425 W University Blvd Ste 102, Durant, Oklahoma |
Authorized Official Name and Position | Deana Tharp (DEPUTY EXECUTIVE DIRECTOR) |
Authorized Official Contact | 5801973053 |
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) 223-5070 | Lighthouse Behavioral Wellness Centers 2425 W University Blvd Ste 102 Durant OK 74701-2970 Ph: (580) 924-7330 |
NPI Number | 1194141309 |
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Provider Enumeration Date | 03/12/2014 |
Last Update Date | 05/20/2020 |
Certification Date | 05/20/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194141309 | NPI | - | NPPES |
100728830 | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 100728830 (Oklahoma) | Primary |
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