| Organization Name: | NORTHERN LIGHTHOUSE DBA NORTHERN LIGHTHOUSE DAY CENTER |
| NPI Number: | 1659601409 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY JO METTLER (PROGRAM ADMINISTRATOR) |
| Mailing Address: | 136 E Redoubt Ave Soldotna |
| State: | AK US |
| Postal Code: | 996698012 |
| Phone Number: | 9073982939 |
| Fax Number: | |
| NPI Enumeration Date: | 12/29/2009 |
| NPI Last Update Date: | 12/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | NONE ISSED BY STATE |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |