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LIGHT HOUSE GROUP HOME LLC
NPI 1154940864
Clinic/Center - Rehabilitation, Substance Use Disorder in Mesa, AZ

Active since April 13, 2020
108 E 2ND AVE STE 101, MESA, AZ 85210(480) 200-1437 Get Directions Write a Review

NPPES record last updated: April 13, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Light House Group Home Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIGHT HOUSE GROUP HOME LLC (NPI 1154940864), doing business as Nova108 Outpatient, is a healthcare organization registered as a rehabilitation, substance use disorder in Mesa, Arizona and active in the NPI registry since April 2020. The organization lists Jeff Presutti, Owner/ceo, as its authorized official.

NPPES Registry Identity

NPI1154940864
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameLIGHT HOUSE GROUP HOME LLC
Location Address108 E 2ND AVE STE 101Mesa, AZ 85210-1410
Mailing Address108 E 2nd AveMesa, AZ 85210-1410
Phone(480) 200-1437
Organization SubpartNo
Authorized OfficialJeff PresuttiOwner/ceo · (480) 332-0385
Enumeration DateApril 13, 2020
NPPES CertifiedApril 13, 2020
✔ NPI 1154940864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
108 E 2ND AVE STE 101, Mesa, AZ 85210
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Other Names 1

Doing Business AsNova108 Outpatient

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Light House Group Home LLC's NPI number?

The NPI number for Light House Group Home LLC is 1154940864. It was assigned to this organization in the NPPES registry on April 13, 2020. The provider is doing business as Nova108 Outpatient.

Where is Light House Group Home LLC located?

Light House Group Home LLC is located at 108 E 2nd Ave Ste 101, Mesa, AZ 85210. The listed phone number is (480) 200-1437.

What is Light House Group Home LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

When was this NPI record last updated?

The NPPES record for Light House Group Home LLC was last updated on April 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.