Lighthouse Care Center of Oconee
Organization Active NPI Adolescent and Children Mental Health Clinic/Center · Tamassee, SC
NPI 1649436015 · NPPES record last updated Oct 7, 2008
Key facts
- NPI
- 1649436015
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adolescent and Children Mental Health Clinic/Center 261QM0855X
- License
- 23245800006 (SC)
- Legal business name
- LIGHTHOUSE CARE CENTER OF OCONEE
- Practice address
- 391 White Rock Rd
Tamassee, SC 29686-2015 - Phone
- (864) 944-9875
- Fax
- (706) 651-7666
- NPI assigned
- Aug 5, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- LIGHTHOUSE CARE CENTER OF AUGUSTA
Authorized official
- Name
- Debby Theis
- Title
- Cfo
- Phone
- (706) 651-0005
National Provider Directory
- Part of
- HHC Augusta Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X | 23245800006 | SC | Yes |
Addresses
Primary practice location
391 White Rock Rd
Tamassee, SC 29686-2015
Mailing address
3100 Perimeter Pkwy
Augusta, GA 30909-4583
Phone (706) 651-0005
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 885MXH | Medicaid | TN |
Other providers in Tamassee, SC
All providers in Tamassee, SC · Adolescent and Children Mental Health Clinic/Center in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.