Light House Village
LBN: Jacksonville Care Llc
Light House Village is an health care organization with primary practice located at 182 Village Dr , Jacksonville NC 28546-7238. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Custodial Care Facility. Nursing & Custodial Care Facilities / Custodial Care Facility is the primary health care specialty.
Jacksonville Care Llc can be contacted via phone (910) 353-7111, or through Pierce, Jacqueline W via phone (336) 643-0555.
Contact Information
Primary practice address
182 Village Dr
Jacksonville NC 28546-7238
Phone: (910) 353-7111
Fax: (910) 353-2799
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Assisted Living Facility | 310400000X | HAL-067-013 | North Carolina |
| Nursing & Custodial Care Facilities / Custodial Care Facility | 311Z00000X | HAL-067-013 | North Carolina |
Profile Details
| NPI number | 1023148434 |
|---|---|
| LBN Legal business name | Jacksonville Care Llc |
| DBA Doing business as | Light House Village |
| Authorized official | Pierce, Jacqueline W |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 6th, 2007 |
| Last updated | Nov 13th, 2023 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023148434 | NPPES |
| North Carolina | MEDICAID | 7804343 |
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