| Lighthouse Behavioral Health Llc | |
|
6109 W Overland Rd # 101 Boise ID 83709-3018 | |
| (208) 713-2311 | |
| Not Available |
| Full Name | Lighthouse Behavioral Health Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 6109 W Overland Rd # 101, Boise, Idaho |
| Authorized Official Name and Position | Mazin Ibraheem (OWNER) |
| Authorized Official Contact | 2087132311 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Behavioral Health Llc 6109 W Overland Rd # 101 Boise ID 83709-3018 Ph: () - | Lighthouse Behavioral Health Llc 6109 W Overland Rd # 101 Boise ID 83709-3018 Ph: (208) 713-2311 |
| NPI Number | 1225822778 |
|---|---|
| Provider Enumeration Date | 04/08/2025 |
| Last Update Date | 04/08/2025 |
| Certification Date | 04/08/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225822778 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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