| Lighthouse Lane LLC | |
|
10409 Montgomery Pkwy Ne Ste 203k Albuquerque NM 87111-3852 | |
| (505) 226-6333 | |
| Not Available |
| Full Name | Lighthouse Lane LLC |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 10409 Montgomery Pkwy Ne Ste 203k, Albuquerque, New Mexico |
| Authorized Official Name and Position | Jessica Ripes (OWNER) |
| Authorized Official Contact | 7022058826 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Lane LLC 10409 Montgomery Pkwy Ne Ste 203k Albuquerque NM 87111-3852 Ph: (505) 226-6333 | Lighthouse Lane LLC 10409 Montgomery Pkwy Ne Ste 203k Albuquerque NM 87111-3852 Ph: (505) 226-6333 |
| NPI Number | 1275406316 |
|---|---|
| Provider Enumeration Date | 09/25/2025 |
| Last Update Date | 09/25/2025 |
| Certification Date | 09/25/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275406316 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | () | Primary |
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