NPI 1134446958

Lighted Path PLLC

Organisation Community/Behavioral Health Agency Conway, AR

Practice location

Address: 1124 Oak St Suite 250, Conway, AR 72032-4318
Phone: (804) 592-1205
Fax: (866) 388-8128
Mailing address: PO Box 224 Suite 250, Conway, AR 72033-0224

Authorised official

Name: Jeremy Lynn Dicicco
Title: President
Phone: (804) 592-1205

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X

Other Community/Behavioral Health providers in Arkansas →

Registry record

NPI: 1134446958
Entity type: Organization
NPI issued: 4 May 2010
Record last updated: 9 Jul 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.