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Contact Information

LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS
2425 W UNIVERSITY BLVD
DURANT, OK74701-2970
 Phone: 580-924-7331
 Fax: 580-924-7332
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Psychiatry

2084P0802X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS

NPI Number 1013542190
LBN Legal business name LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS
Authorized official DEANA THARP - (DEPUTY EXECUTIVE DIRECTCOR)
Entity Organization
Organization subpart 1 No
Enumeration date 03/09/2020
Last updated 05/20/2020 - About 6 years ago
Identifiers
OK Medicaid 100728830
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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