LIGHTHOUSE FOR RECOVERY LLC NPI 1013298058

NPI Information

NPI: 1013298058
Provider Name: LIGHTHOUSE FOR RECOVERY, LLC
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
1135 YELLOWSTONE AVE
SUITE D
POCATELLO, ID
ZIP 83201
Phone: (208) 232-2908
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LIGHTHOUSE FOR RECOVERY, LLC is an addiction (substance use disorder) counselor in Pocatello, ID. LIGHTHOUSE FOR RECOVERY, LLC NPI is 1013298058. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1135 YELLOWSTONE AVE
SUITE D
POCATELLO, ID
ZIP 83201-082
Phone: (208) 232-2908
Fax: (208) 232-5423

The provider's authorized official is William C. Slaven .
The authorized official title is Executive Director and has the following contact phone number (208) 237-3365.

The enumeration date for this NPI number is 9/5/2011 and was last updated on 9/5/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	LCSW 28016	IDAHO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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