Organization · Type 2 NPI
The Lighthouse - Traverse City, LLC
Physical Disabilities Residential Treatment Facility · Kingsley, MI
NPI number
1649359316
Active
Practice location
4140 Beacon St
Kingsley, MI 49649
Fax (231) 263-1353
Mailing address
PO Box 289
Caro, MI 48723-0289
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Custodial Care Facility | 311Z00000X | None listed |
| Intellectual and/or Developmental Disabilities Residential Treatment Facility | 320600000X | None listed |
| Physical Disabilities Residential Treatment Facility Primary | 320700000X | None listed |
Physical Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with physical disabilities and are not able to live independently.
Another provider at this address
About NPI 1649359316
The Lighthouse - Traverse City, LLC's National Provider Identifier is 1649359316, issued on Nov 3, 2006. The primary taxonomy on file is Physical Disabilities Residential Treatment Facility (320700000X), and the practice location is in Kingsley, MI. The record was last updated on Jan 28, 2013.