LIGHT HOUSE VILLAGE
NPI 1023148434
Custodial Care Facility in Jacksonville, NC
NPI Status: Active since March 06, 2007
Contact Information
182 VILLAGE DR
JACKSONVILLE, NC
ZIP 28546
Phone: (910) 353-7111
Fax: (910) 353-2799
- Organization
- Custodial Care Facility
- CLIA Number: 34D1017014
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 05-22-2026
About LIGHT HOUSE VILLAGE
This page provides the complete NPI Profile along with additional information for Light House Village, a provider established in Jacksonville, North Carolina operating as a Custodial Care Facility. The healthcare provider is registered in the NPI registry with number 1023148434 assigned on March 2007. The practitioner's primary taxonomy code is 311Z00000X with license number HAL-067-013 (NC). The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's other name is Light House Village. The authorized official of this NPI record is Mrs. Jacqueline W Pierce (Managing Member)
- NPI
- 1023148434
- Provider Legal Name
- JACKSONVILLE CARE LLC
- Other Organization Name
- LIGHT HOUSE VILLAGE
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 182 VILLAGE DR JACKSONVILLE, NC 28546
- Location Phone
- (910) 353-7111
- Location Fax
- (910) 353-2799
- Mailing Address
- PO BOX 878 OAK RIDGE, NC 27310
- Mailing Phone
- (336) 643-0555
- Mailing Fax
- (910) 353-2799
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-06-2007
- Last Update Date
- 11-13-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Custodial Care Facility
- Taxonomy Code
- 311Z00000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- HAL-067-013
- License State
- NC
- Taxonomy Description
- A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | HAL-067-013 (NC) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7804343 | MEDICAID (05) | NC |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D1017014
- Facility Type
- Community Clinic
- Certificate Effective Date
- September 15, 2003
- Certificate Expiration Date
- May 22, 2026
- Laboratory Director
- NING CAI
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Light House Village on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1023148434, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1023148434, enumerated as an "organization" on March 06, 2007.
The provider is located at 182 VILLAGE DR JACKSONVILLE, NC 28546 and the phone number is (910) 353-7111.
Custodial Care Facility with taxonomy code 311Z00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
