Light House Group

LBN: Light House Group
Light House Group is an health care organization with primary practice located at 206 Wapiti Dr 108 Ashton Pl, Spring Lake NC 28390-1530. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Light House Group can be contacted via phone (910) 497-0299, or through Davenport, Charles via phone (910) 497-0299.

Contact Information

Primary practice address
206 Wapiti Dr 108 Ashton Pl Spring Lake NC 28390-1530
Phone: (910) 497-0299
Fax: (910) 497-0297
Website:
Map and Directions
Authorized official contact:
Name: Davenport, Charles
Phone: (910) 497-0299

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X MHL -026-805 North Carolina
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X MHL-026-782 North Carolina
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X MHL-026-627 North Carolina

Profile Details

NPI number 1225166069
LBN Legal business name Light House Group
DBA Doing business as
Authorized official Davenport, Charles
Entity Organization
Organization subpart 1 No
Enumeration date Mar 2nd, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225166069 NPPES
North Carolina MEDICAID 6603194
North Carolina MEDICAID 6603652
North Carolina MEDICAID 6603907

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