| Lighthouse Youth Services Inc. | |
|
1071 Tong Hollow Rd Bainbridge OH 45612-9421 | |
| (740) 634-3094 | |
| (740) 634-3047 |
| Full Name | Lighthouse Youth Services Inc. |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1071 Tong Hollow Rd, Bainbridge, Ohio |
| Authorized Official Name and Position | Thuy Kolik (VICE PRESIDENT, CFO & CAO) |
| Authorized Official Contact | 5134877106 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Youth Services Inc. 401 E Mcmillan St Cincinnati OH 45206-1922 Ph: (513) 487-7106 | Lighthouse Youth Services Inc. 1071 Tong Hollow Rd Bainbridge OH 45612-9421 Ph: (740) 634-3094 |
| NPI Number | 1053389841 |
|---|---|
| Provider Enumeration Date | 03/09/2006 |
| Last Update Date | 04/07/2025 |
| Certification Date | 04/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053389841 | NPI | - | NPPES |
| 06883 | Other | OH | ALCOHOL & DRUG TREATMENT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (Ohio) | Primary |
| 291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Secondary |