LIGHT HOUSE GROUP
NPI 1225166069
Residential Treatment Facility, Emotionally Disturbed Children in Spring Lake, NC

Q: What is Light House Group's NPI number?

The NPI number for Light House Group is 1225166069. It was assigned to this organization in the NPPES registry on March 2, 2007.

Q: What is Light House Group's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

Q: When was this NPI record last updated?

The NPPES record for Light House Group was last updated on August 22, 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.

Active since March 02, 2007

206 WAPITI DR, 108 ASHTON PL, SPRING LAKE, NC 28390(910) 497-0299(910) 497-0297 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Light House Group NPPES

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

LIGHT HOUSE GROUP (NPI 1225166069) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Spring Lake, North Carolina and active in the NPI registry since March 2007. The organization lists Charles Davenport, President, as its authorized official.

NPPES Registry Identity

NPI1225166069

Entity TypeOrganization

Primary Taxonomy322D00000X

Legal Business NameLIGHT HOUSE GROUP

Location Address206 WAPITI DR, 108 ASHTON PLSpring Lake, NC 28390-1530

Mailing Address408 Harrell St, Po Box 1089Spring Lake, NC 28390-3607 · (910) 497-0299 · Fax (910) 497-0297

Phone(910) 497-0299

Fax(910) 497-0297

Organization SubpartNo

Authorized OfficialCharles DavenportPresident · (910) 497-0299

Enumeration DateMarch 2, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1225166069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities

Taxonomy Code322D00000X

Licenses✔ Licensed in NC · MHL-026-627✔ Licensed in NC · MHL -026-805✔ Licensed in NC · MHL-026-782

Definition

A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

206 WAPITI DR, Spring Lake, NC 28390

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Other Identifiers 3

Medicaid6603652NC

Medicaid6603194NC

Medicaid6603907NC

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's NPI number?

The NPI number for Light House Group is 1225166069. It was assigned to this organization in the NPPES registry on March 2, 2007.

Where is Light House Group located?

Light House Group is located at 206 Wapiti Dr 108 Ashton Pl, Spring Lake, NC 28390. The listed phone number is (910) 497-0299.

What is Light House Group's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

When was this NPI record last updated?

The NPPES record for Light House Group was last updated on August 22, 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.