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Light House Group Home Llc
Substance Abuse Rehabilitation Facility in Mesa, Arizona
NPI 1316505753

Light House Group Home Llc is a Substance Abuse Rehabilitation Facility based in Mesa, AZ. Light House Group Home Llc practices in Mesa, AZ. The NPI Number for Light House Group Home Llc is 1316505753 and holds a License No. (Arizona).

The current practice location address for Light House Group Home Llc is 108 E 2Nd Ave, Mesa, AZ and can be reached out via phone at 480-332-0385.

Location: 108 E 2Nd Ave, Mesa, AZ, 85207-5351
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1316505753
Provider Name
Light House Group Home Llc
Credential
Provider Entity Type
Organization
Address
108 E 2Nd Ave, Mesa, AZ, 85207-5351
Phone Number
480-332-0385
Fax Number
Provider Enumeration Date
05/31/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
108 E 2Nd Ave
City
Mesa
State
Arizona
Zip
85210-1410
Phone Number
480-332-0385
Fax Number
person
Provider Business Mailing Address Details
Address
108 E 2Nd Ave
City
Mesa
State
Arizona
Zip
85210-1410
Phone Number
480-332-0385
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Substance Abuse Rehabilitation Facility
Speciality
-
Taxonomy
324500000X
License No.
()
Definition
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
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