| Lighthouse Family Service Center | |
|
150 Stanley Ct Ste B Lawrenceville GA 30046-5215 | |
| (404) 419-6404 | |
| Not Available |
| Full Name | Lighthouse Family Service Center |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 150 Stanley Ct Ste B, Lawrenceville, Georgia |
| Authorized Official Name and Position | Widline Dalambert-ducena (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4044196404 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Family Service Center 150 Stanley Ct Ste B Lawrenceville GA 30046-5215 Ph: () - | Lighthouse Family Service Center 150 Stanley Ct Ste B Lawrenceville GA 30046-5215 Ph: (404) 419-6404 |
| NPI Number | 1134735202 |
|---|---|
| Provider Enumeration Date | 09/23/2020 |
| Last Update Date | 09/23/2020 |
| Certification Date | 09/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134735202 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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